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It’s not everyday that a person settles their personal injury case. Getting your money from a personal injury settlement is a completely new process which you haven’t experienced, and thus, likely don’t understand.

The settlement money does not magically appear in your bank account the moment after your case settles.  If you attend at your lawyer’s office, the money does not magically appear either. There are still a few steps which need to be done. Those steps take place behind the scenes, and, for the most part, they are completely out of your control; and out of the control of your personal injury lawyer. But, understanding those steps might bring you a bit of peace of mind and will help you remain patient while you wait for the settlement funds to become available.

If you’ve made a deal with the insurance company with the help of your personal injury lawyer, the one thing you can do to move things forward is to sign the Release. If you don’t sign the Release, then the deal is not finalized and the insurance company will not requisition the cheque from their accounting department.

When a personal injury case settles, the Defendant/Insurer will require the Plaintiff to sign a Release. This is standard. Anyone who settles their case outside of Court will need to sign a Release. It will say in legalese that the case has settled for a specified amount; that the Plaintiff will NOT sue again over that specific accident/injury; and that the Plaintiff will not share the fact that the case settled all over town (a confidentiality clause is sometimes there, sometimes not). The faster which a Plaintiff signs the Release, the faster the settlement funds will be requisitioned by the insurance company.

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Nathan Fielder has a show called “The Rehearsal“. It’s a hard show to explain. You have to see it to believe it. I find it hard to understand how the show was green lit by executives on words or a script alone. It was green lit on the genious and creativity of Nathan Fielder.

The premise, is that Nathan is obsessed about a problem and he wants to get to the route of it in order to solve the problem or make it better. Nathan believes that everything in life would be easier, if you were able to rehearse it over, and over again, until you got it right. That makes sense, but it’s completely impractical which is what makes the show so entertaining. Nathan is so obsessed with the problem that he creates an exact simulation (to the minutest of details) and rehearses the scenario it over, and over again until he better understands what’s happening so that he can get to the route of the problem and solve it. He creates intricate sets which are the exact replicas of reality; hires actors to best simulate the reality of mundane situations; and repeats scenarios over and over again until he gets them right.

It’s a wonderful premise. In part, because it’s so unrealistic in terms of the levels of time, money, effort and energy which are invested into these otherwise mundane scenarios which an ordinary person would not think twice about.

Funny enough, personal injury lawyers do a lot of rehearsing with our clients. This is called client preparation. Our law firm runs “prep sessions” for our clients before big touchstone events in their cases so that they know what to expect and so that they can perform at their best.

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You know when you’ve been approved for Long Term Disability Benefits. That approval will usually come first verbally, and then be formalized in writing.

While, getting something in writing from the long term disability insurer might feel good, it doesn’t mean anything until the payments start coming in.

That rings true in real world examples:

Let’s say you hear from your adjuster that benefits have been approved. Great!

Then, you receive a letter from the insurance company which formalizes the approval in writing. Great again!

But, as Jerry McGuire would say “Show me the Money“.

When the insurer does examines your file, looks at how much money you made, and how much money you’ve received from other collateral sources, it turns out that the benefit owing to you amounts to ZERO! That means that the long term disability insurer’s approval amounts to no tangible benefits for you; even though you’ve been approved. The reality is that you’ve been approved for nothing!

In that same example, it might be that the insurer had been paying you long term disability benefits. Then, they stopped because you received collateral benefits (like CPP Disability Benefits). Then, having reviewed your file, along with the amounts paid to you in long term disability benefits vs. the amounts paid to you in CPP Disability benefits; it turns out that the long term disability insurer over paid you. Now, they are seeking a repayment of benefits due to the over payment. This means that you owe the long term disability insurer money. Imagine that: a person owing an insurance company money for a over payment (completely unrelated to payments of insurance premiums).

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Insurance companies love jury trials for personal injury cases.

But getting a trial by way of Jury trial is not automatic. The default is that the personal injury trial proceed by way of Judge alone. Having a personal injury case heard by way of Judge alone simplifies the trial itself. It’s less complex. Less lengthy. Takes up fewer Court resources. It’s cheaper, more efficient and more cost effective. How many times have you heard of a mistrial involving a Jury case because of some shenanigans involving the jury itself? Lots! Now; how many times have you heard of a mistrial by way of Judge alone? Not many! That’s because when the trial proceeds by way of Judge alone, there are fewer changes at disaster happening. These are undeniable truths.

A personal injury case which is proceeding by way of Judge alone can quickly be converted to a Jury trial if either party files a “Jury Notice”. The cost for filing a Jury Notice in a personal injury case is only $138. Insurance companies file Jury Notices as a knee jerk response to defending claims. And, all for the low, low price of $138, the framework of the case has been changed completely.

Why do insurance companies want personal injury cases to be tried by a Jury, and not by way of Judge alone? Good question!

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Critical Illness sounds like a great deal.

If you purchase a Critical Illness Policy of insurance, and you get diagnosed with any of the illnesses identified under the policy, you get paid a great big lump sum of cash.

Depending on the policy and the premiums you get paid, that lump sum could be $100,000; $250,000, $500,000 or even $1,000,000 or greater.

Sounds too good to be true; right?

But beware. Things aren’t always as they appear. When things sound too good to be true, that’s often because they are.

Critical Illness policies are marketed in such a way to seem like they are a safety net should things go wrong. And sometimes, things go really wrong and the policies pay out. But, in my experience, more often than not, insurers find a way to get out of paying benefits.

I call it a bait and switch.

What do I mean by that? Let’s take a look.

Insurers cleverly market these policies as an affordable means to get coverage. They are “living policies”. That means that the recipient of the benefits is generally alive in order to recover benefits. These policies aren’t life insurance. Nor are they disability insurance. One of the triggering events needs to happen, and the person must survive the triggering event.

Those illnesses, or triggering events can be plentiful. They are marketed in a broad based way, like “cancer” is covered. The insurer doesn’t into great detail about the sort of cancer, or the severity or stage of the cancer.  They simply market the coverage as for cancer. Or a heart attack. Broad and general terms are first used to lure a customer in. And that luring is very tempting. Cancer and heart attacks are quite common. So, buying insurance to cover such claims makes sense on first review.

Here are a few other common critical illnesses which are marketed to consumers in broad terms:

Cancer

  • Cancer of specified severity

Heart Conditions

  • Aortic surgery
  • Cardiomyopathy
  • Coronary artery bypass surgery
  • Heart attack
  • Heart valve replacement or repair

Neurological Conditions

  • Stroke
  • Acquired brain injury
  • Bacterial meningitis
  • Benign brain tumor
  • Coma
  • Dementia, including Alzheimer’s Disease
  • Motor neuron disease (incl. ALS)
  • Parkinson’s Disease and specified atypical Parkinsonian disorders
  • Paralysis

Autoimmune Conditions

  • Aplastic anaemia
  • Multiple sclerosis
  • Occupational HIV infection

Sensory & Mobility Conditions

  • Blindness
  • Deafness
  • Loss of limbs
  • Loss of speech
  • Loss of independent existence
  • Severe burns

Transplants & Organ-Related Conditions

  • Kidney failure
  • Major organ transplant
  • Major organ failure on waiting list

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After hearing the news that long time retailer Hudson’s Bay Company declared bankruptcy, my mind immediately went to the employees at HBC. The part timers. The full timers. The seasonal employees. The student employees. The “lifers”. The night shift employees. The early birds who stock the shelves. The office workers. The shipping and receiving crew. The janitorial staff. Everyone who makes the stores work.

I know that life well.

Before I became a personal injury lawyer, I worked retail at Sears Canada while I was in undergrad at York University. I worked in the hardware department and in the paint department. I saw the ins and outs of a large department store. I learned all sorts of things about paint, tools, brushes, stains, lawnmowers, power washers, dehumidifiers…. You name the home appliance/tool, I knew about it.

But, more importantly, I learned a lot about people from all walks of life, and how large publicly traded companies work and treat their workers.

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Most people aren’t familiar with how car insurance disputes work until they have to go through the process.

Most would think that if there’s a dispute for benefits, they can sue the insurer which is denying those benefits and then a Judge can decide. That seems simple and straight forward. Unfortunately, simple and straight forward is not the way which car accident cases work in Ontario.

Long ago, accident victims had the right to sue the insurance company which was denying their accident benefits following a car accident. That case could be heard by a Judge, in regular Court. The court date however would only trigger if the parties had attempted and failed a mediation at the Financial Services Commission of Ontario (FSCO). That way, the parties gave it an honest try to see if they could resolve their dispute at mediation, without the need for litigation in Court. This made a lot of sense, and was easy for unsophisticated and inexperienced litigants to understand.

But the rights of accident victims to sue over denied accident benefits following a car accident were stripped from everyone in Ontario. Yes: imagine that. In a democracy, the government took away your right to sue, and access to the Courts.

Instead, innocent accident victims were required to have their disputes heard at the License Appeals Tribunal (LAT). The LAT is not a Court. It’s a tribunal. There are no Judges at the LAT. Instead, there are adjudicators who work there, who may, or may not, have any experience hearing or ruling on car accident cases. The barrier to entry to become an adjudicator at the LAT is much lower than the barrier to entry to become a Judge of the Ontario Superior Court of Justice.

Since the LAT became the ruling body over accident benefit disputes, it’s been an unfriendly place to accident victims (likely by design), and surrounded with controversy. It’s a really strange place.

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The Ontario Government has proposed legislation to create “special economic zones” in order to speed up large scale projects such as the Ring of Fire, and a proposed tunnel under highway 401 in order to reduce traffic.

The Bill is called Protect Ontario by Unleashing our Economy Act (Bill 5 ) detailed of which can be found here. 

As an aside, I love it how governments name their bills. Be forewarned. The name of bills often does the exact opposite of it’s name. It’s a PR play in an attempt at misdirection (kinda like how a magician pulls off a magic trick). It gets the public to look one way; or to think about the legislation in one way; in order to misdirect the public from seeing all of the bad stuff happening which is actually going to happen in a different direction. It’s a way for the government to create a narrative in a way which directs people away from the ugly truth of what’s actually going to take place. The Bill, called “Protect Ontario by Unleashing our Economy Act”, could also be aptly named  the “Stripping All of Your Rights so We Can Dig Out Minerals and Build Stuff Really Really Quickly Act“.

If passed, the new law would allow the Ontario government to disregard any provincial laws currently in place (such as provincial environment, labour or insurance act rules) in order to get the project done as quickly as possible, without any red tape. The bill cuts all of the checks and balances in place to protect the public and to protect the environment. It’s being sold to the public as a way to kick start the economy over the threat of Donald Trump and tariffs being imposed by the United States on Canada and Ontario.

It might sound like a good idea, until you pause and think about the ramifications of the proposed bill to plow through all other bills.

For starters, the bill seems completely undemocratic, and borderline totalitarian. The piece of legislation allows the government to do whatever it wants; ignoring legislation what has existed for many years. The rules and laws won’t apply to them once this piece of legislation has passed, and is used. Even if it’s challenged in the Courts as a violation of a Charter Right, the government can enact the Notwithstanding Clause in order to get their way. The Ford Government has used the Notwithstanding Clause before; meaning that they won’t be afraid to use it again. It gives the government total and complete control. That’s what happens when a majority government has been elected. It’s their “mandate“. But, if this piece of legislation were put to a vote, I doubt that the majority on Ontarians would stand behind the idea of giving such power to the government.

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It’s not mistake that Long term disability claims use the word “long“. Long is used for good reason.

Long is meant to define the duration of the period from the claimant’s first day off work, to the time period they are eligible to receive long term disability benefits. It’s a “long” period in contrast to a “short” period as found in short term disability claims.

Long also defines the duration for which the claimant is eligible to receive long term disability benefits. That period is longer than you would find in short term disability cases. In most long term disability cases, the eligibility period, or payment period, generally goes up to the age of 65. But, this is fact dependent upon the wording contained in the long term disability policy. In contrast, the duration of short term disability benefits is generally a few months (90 days, 120 days). This too is fact dependent and is specific to the wording of the policy. In any event, the use of the word “long” is meant to distinguish from the use of the word “short” in the case of disability policies.

For personal injury lawyers, and for many disability claimants, the use of the word “long” can also mean something completely different. It can be seen as a reminder to the claimant that it may take a long time to get an answer from the insurance company on whether or not the claim for benefits has been approved or denied.

In other circumstances, it can take a long time for the claimant to get paid their benefits, even after they’ve been approved.

For lawyers, the use of the word “long” is a gentle reminder that long term disability cases take time get through the Courts, or to ultimately resolve by way of Judgment or out of Court Settlement. Make no mistake, there is nothing “short” about a long term disability case once it’s been litigated.

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When an international student or a visitor to Canada has a serious accident in Ontario, it can get very complicated.

Who will pay for the medical treatment? The hospital visits? The ambulance? The out of pocket expenses? What about the loss of opportunity to pursue their studies, or the wage loss from a part time job?

These are really hard questions, and all depend on the facts of the case, along with the coverage of the injured party.

For starters, people in Canada on Student Visas, or a Visitors Permit won’t have access to the publicly funded OHIP system, the same way that Canadian Resident will. This is why it’s so important for the student or visitor to Canada to make sure that they have proper health care coverage before they come to Canada.

Having bad insurance will end up in a less desirable result. Just because an insurance plan is the cheapest, doesn’t mean that it’s the best. Often, you get what you pay for. Nobody ever expects to be involved in a serious accident, but if one happens, it sure helps to have a responsive and supportive insurer; rather than an insurance company which is the habit of denying claims, or being non-responsive to their insured.

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