Articles Posted in Car Accident

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It seems that every few months or so, the Toronto Injury Lawyer Blog is discussing the topics to changes in car insurance and accident benefit disputes in Ontario. Is it because we LOVE blogging about accident benefits? Not really. Accident benefits are quite frankly, an incredibly complicated and dense area of the law. The rules for accident benefits, in many respects, are made in favour of large insurance companies and designed to limit an injured claimant’s ability to recover an income. It’s not a committee of accident victims who sit around and make these laws, and tweek them ever so slightly. Rather, it’s deep pocketed insurers and so called “insurance experts” who do so at the behest of the large insurance lobby.

A few quick examples of some arbitrary decisions which accident benefit laws have imposed:

  • No monetary reimbursement for a trip to the doctor which is under 50km. Why 50km? Who picked the 50km distance? Your guess is as good as mine
  • A maximum recovery of just $3,500 for soft tissue injuries which are classified to fit under the Minor Injury Guideline. Why just $3,500? Because that’s what insurers and our government deems to be reasonable. Interesting enough, that $3,500 is less than you paying the full value of your car insurance premiums over a 3 year period in Toronto, London, Ottawa or another large city in Ontario.
  • A maximum recover of $50,000 for claims which aren’t catastrophic, but not Minor. Why a $50,000 limit? Beats me.
  • An income replacement benefit of a maximum of just $400/week under a standard Ontario Automobile Policy, which has NOT increased to reflect inflation over the past 15 years.
  • A deductible which will be increasing from $30,000 to $36,500 for pain and suffering claims. Why $36,500? Beats me.

As you can see, many of the monetary limits imposed in accident benefit law in Ontario are just numbers which seem to be picked out of a hat to favour insurers. Not once have I ever met an injured accident victim, or an ordinary person who believes that these limits are reasonable or helpful for claims.

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The OCF-6 Application for Expenses or Expenses Claim Form is the MOST IMPORTANT FORM to get paid back for your out of pocket expenses following a car or motor vehicle accident.

Immediately after a serious accident, the bills and expenses can quickly add up. Hospital parking is a fortune these days. Hospital meals, medication, the ambulance bill, damaged clothing, broken glasses, equipment rental for ramps, crutches, a wheelchair or simply purchasing a cheap cane from a drug store. All of these expenses quickly add up.

Some of the first questions from prospective clients isn’t how much their case is worth. It’s how can I get re-reimbursed for my out of pocket expenses?

I’ve always found this a bit odd; but I suppose it’s human nature. In the context of a multi million dollar claim, we are worried and insurers fight over the smaller $10 expenses; yet they are willing to pay out $1,500/month for attendant care benefits without issue; or pay out much larger amounts on a periodic basis.

In any event, the purpose of this Toronto Injury Lawyer Blog is to assist you in preparing your OCF-6 the right way, so that your out of pocket expense claims gets approved instead of denied.

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Around this time of the year, our law firm receives a noticeable spike in pedestrian collision claims. These are the sort of cases where somebody is trying to cross the street (on foot), and they get hit by a car, or some other sort of motor vehicle (even a bike).

What explains the spike is anybody’s guess. But, it would make sense that near the end of October we get less daylight, making visibility more difficult for motorists, cyclists and pedestrians alike. We also have some worse weather which can lead to visibility issues as well. And who can forget the Halloween Holiday, whereby residential streets are flooded with trick or treaters in full blown costume.

At the time of preparing the Toronto Injury Lawyer Blog Post, at least 12 pedestrians were hit by cars around the General Toronto Area during the commuting periods. Some new outlets have the number as high as 16 pedestrian collisions throughout the course of the day. That’ a lot! Police are attributing this spike to poor visibility on account of decreased daylight and bad weather. This was one of the first days of the fall where the weather was rather cold, damp and dark.

Scary because Halloween is right around the corner and you get the sneaking suspicion that people can’t drive safely anymore? Scary because you get the feeling that motorists don’t have respect for other motorists, cyclists or pedestrians? I know the feeling. Adding insult to injury is that the penalties handed out by our Courts following a breach of the Highway Traffic Act are akin to slaps on the wrist. A few demerit points, a license suspension, a fine. None of these penalties are proportional to the devastating impact a serious car accident can have on an innocent accident victim and their family.

There are a lot of young parents who read the Toronto Injury Lawyer Blog. Having a young family of my own, I want to share with you some of Goldfinger Injury Lawyers’s top tips on how to keep Halloween safe when you’re outside trick or treating this holiday season. If the recent trend of motorists colliding with pedestrians continues, I’m certain you can use these tips. I’ll do my best to give you some out of the box tips you may not have even thought of aside from the usual ones you may see in other media online.

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The balance between access to justice vs. the goals of expediency, affordability and proportionality of the civil justice system were weighed in the case of Anjum et. al. v. Doe et. al. Here, it was ruled that a defendant insurer would be permitted to bring a 3 day summary judgment motion requiring viva voce evidence from a catastrophically injured Plaintiff along with evidence from competing experts on both sides.

The practical effect, although expressly denied in the decision, is that the parties are having an expensive and time consuming three day mini trial on liability, without a jury.

The Plaintiff Anjum was involved in an alleged hit and run car accident which caused catastrophic injuries. Anjum could not identify the vehicle that hit him, so he sued his own insurer, State Farm under the unidentified motorist coverage under his policy.

State Farm denied that there was any evidence indicating involvement from another vehicle and brought a summary judgment motion along these lines.

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One of the hardest things for people to understand in Ontario is how our No Fault system of car insurance works.

Ask 10 drivers how their no fault accident benefits work, or how no fault car insurance works, you’ll get 10 different answers. All of them will likely be wrong. Ask 10 lawyers who don’t practice in the field of persona injury law, you’ll probably get the same wrong answers! Even funnier is if you ask 10 different politicians, the ones who actually passed the laws to create no fault accident benefit insurance in Ontario, and they won’t know either.

The only people who truly know how no fault insurance and accident benefits work are personal injury lawyers, insurance defence lawyers, people who work for insurance companies and those service providers who routinely bill insurers through IEs or through OCF claim forms.

What people have a hard time understanding, is that after an accident involving the “use or operation of a motor vehicle” , they will have TWO SEPARATE CLAIMS. The first claim is the claim for no fault accident benefits. These claims are guaranteed provided there are no policy breach issues. This first accident benefit claim is against your OWN INSURER, regardless of fault. If you didn’t have car insurance at the time of the accident, then there are loss transfer provisions under the Insurance Act which create a duty to defend or respond to the claim from another insurer, or, in the last case scenario, from the Ontario Motor Vehicle Accident Claims Fund. These accident benefits will cover such things as medical/rehab benefits, attendant care benefits, non earner benefits, income replacement benefits and out of pocket expenses related to the car accident. Accident Benefits do NOT cover pain and suffering.

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After you’ve been involved in a car accident, there are A LOT of forms to complete for the insurance company in order for you to start recovering benefits.

It’s not simple. You have to jump through a lot of hoops. The process can be long, tedious and very frustrating.

Why don’t they just make the process simple? I have no idea. The forms are created by the government, but are heavily influenced by the lobbying efforts of large insurance companies. So, the forms, along with the questions in the forms are skewed from the outset to create a bias against innocent accident victims and in favour of large, deep pocked insurance companies.

If English isn’t your first language, or you have problems completing paper work; or you have sustained a brain injury in the accident, then completing these forms will be particularly difficult. Get a lawyer to help you out.

The purpose of this Toronto Injury Lawyer Blog Post is to assist you in completing the somewhat tricky OCF-3 Disability Certificate follow a car accident.

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This Civic Holiday was a time to relax, enjoy time spent with the family, along with some nice weather….For most.

For insurers and the Ontario Government, it was a time to reign in some new changes to the Insurance Act which were swept under the rug. Unbeknownst to Ontario drivers, the value of the pain and suffering and their injuries following a serious car accident claim have been diminished yet again at the behest of large, deep pocketed insurance companies.

So; what are these changes of which I speak?

Many of you may not know this, but there is a deductible for pain and suffering claims (tort) following a car accident.

Back in the 1970’s there was no such deductible. This meant that you could sue, and recover compensation at law for large injuries and for smaller ones. If the accident wasn’t your fault, and you got injured, chances are you would be able to recover some form of compensation for your pain and suffering.

After the introduction of no fault insurance in Ontario, a deductible and a threshold were both introduced in order to limit the recovery of accident victims in the guise of saving insurers money on claims. The hope was that fewer claims would be advanced, thereby reducing the expenses for insurers. Those savings were supposed to be passed along to the consumer in the form of lower car insurance rates. That deductible has soared from $10,000; to $15,000; to $30,000.

So what’s the significance of the August 1, 2015 date?

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Here’s a call NOBODY likes to get:

“This is the Social Worker from your local hospital. Your spouse has been involved in a serious car accident. They’re here in the Critical Care Unit. Their condition is stable, but you should come to the hospital right away“.

Your heart will skip a beat or two; and rightfully so. This is something you would never expect or want to happen. Millions of questions, concerns and grim scenarios are likely rushing through you head.

This first thing to do of course is to get to the hospital to be next to your spouse/loved one. Soon after the situation will stabilize and the next steps are very important. Here are some of Goldfinger Injury Lawyers’s tips on what to do if your spouse or loved one is in the hospital with a serious injury.

1. You should know that if anyone contacts you from any insurance company, you are under no obligation to speak with them. Chances are that if an insurance company has heard about this accident, they will want to get some information right away. Naturally, people want to be helpful and share information with the insurer. But, often times, the information which you are providing to an insurer without the assistance of a lawyer can damage your case right from the get go. Insurers won’t stop calling. It’s their job. I’ve actually seen adjusters arrive at an injured party’s bedside while they are medicated in a hospital bed and get them to sign forms and take a statement from them. This is all done under the guise of “information gathering”, but the reality is that they are slowly building their case at limiting their potential exposure and liability. Don’t speak with an insurer without a lawyer. You don’t have to take their calls if you don’t want to. It’s that simple.

2. Co-operate with the police. The police, much like insurers have fact gathering missions. But unlike insurers, the fact gathering missions of the police serve a much different purpose. If you’re more comfortable dealing with the police with a lawyer; then by all means, seek one out. But if the accident wasn’t your fault, then you should have nothing to hide. The police will want to bust the wrong doer just as bad as you for their negligence or bad decisions. It’s beneficial to your case to co-operate with the police as best you can.

3. Follow your doctor’s recommendations: if the doctor recommends that you stay in hospital an extra day, or get discharged to a long term care facility; then do so. Even if all you want to do is go home; or you have no interest in going to a long term care facility; the doctor knows best. Follow their advice so you can get better. It’s never good for a case, or for your health for that matter if you fail to follow a doctor’s orders. Particularly after a bad car accident.

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You’ve been injured in a car accident, or you’ve made a claim for Long Term Disability Benefits.

Benefits have not yet been paid. The insurance is giving you a tough time. They’re treating you like you’ve done something wrong; when all you’ve done is been in the wrong place at the wrong time resulting in serious injuries. All you want are the benefits you need to help you get better, and make ends meet. After all, isn’t that what insurance is for? Isn’t that why you’ve paid mountains of money in premiums all of these years.

You receive a notice in the mail from your insurer. They want you to attend an IME (Independent Medical Examination) with some doctor or therapist who you’ve never heard of, in a strip plaza or office tower that’s far away from home.

Transportation has been arranged, but the assessment is still going to take up a lot of your time.

You have yet to receive any benefits so why should you bother to attend? You don’t want some strange doctor or therapist touching you, or asking you all sorts of personal questions, and then reporting their findings to strangers at the insurance company. It all seems weird. And who’s paying for these examinations anyway? They aren’t covered by OHIP, and you know that doctors’ time isn’t cheap.

If the request for an IME is as a result of a car accident, unfortunately, the Insurance Act and the Statutory Accident Benefits Schedule (that’s the law dealing with car accident benefit claims) requires that you attend.

Here is an excerpt of the relevant section of the SABS:

Examination Required by Insurer

42.  (1)  For the purposes of assisting an insurer determine if an insured person is or continues to be entitled to a benefit under this Regulation for which an application is made, an insurer may, as often as is reasonably necessary, require an insured person to be examined under this section by one or more persons chosen by the insurer who are members of a health profession or are social workers or who have knowledge in vocational rehabilitation. O. Reg. 546/05, s. 21.

So, you’ve now read the law which basically requires your attendance at these examinations. Still..what happens if you just don’t go? Read on and we will tell you!

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For many, this May long weekend marks the official beginning of spring/summer; depending on how you evaluate the temperature. After a very long, cold and windy winter, this May long weekend is a warm welcome; even if the temperatures aren’t “July in Windsor warm“.

As an accident lawyer, our firm has seen many cases over the years, which have stemmed from negligence or bad decisions over long weekends.

With this edition of the Toronto Injury Lawyer Blog, we wanted to give you some safety tips; do’s and dont’s; to make sure that this May long weekend is a pleasant and safe one, for you, your family and those around you.

1. Don’t drink and drive. Whether it’s a car, motorcycle, ATV, E-bike, Sea-doo, or a boat; alcohol and motor engines don’t mix. I can’t begin to tell you about the spike in calls that our law firm receives following long weekends with respect to alcohol related injuries, or drunk driving accidents. When you drink, your judgement is impaired. So is your co-ordination. Getting behind the wheel of a motor vehicle after drinking not only puts your own life at risk, but also the lives of your passengers and other motorists with whom you’re sharing the road or waterway. We all have seen the public service advertisements from such groups as Mothers Against Drunk Driving, or Ontario Students Against Impaired Driving. Driving drunk is ALWAYS a bad decision whereby you’re putting somebody’s life at risk. The consequences can last forever so be smart about it.

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