Our office gets a number of calls every week from people wanting to know if they qualify for Long Term Disability (“LTD”) benefits; how they can make a claim; or just how their LTD policy works.
This article in intended to give you a bit of help in better understanding the complicated world of Long Term Disability Benefits.
In the case of Keam v. Caddey, the Ontario Court of Appeal ordered that the insurance company pay to the Plaintiff $40,000 in ADDITION to damages for pain and suffering because the insurance company REFUSED to participate in the mediation process before the case went to trial. The Insurance Act REQUIRES that parties in a car accident case MEDIATE the disputes before it goes to trial. Our legistlature has also called for Mandatory Mediation in certain provincial jursidictions, like Toronto. The Ontario Court of Appeal found that the insurance company’s hard ball tactic of REFUSING to MEDIATE warranted a $40,000 penalty against the insurer.
The Honourable Justice Kathryn Feldman writing for the Ontario Court of Appeal stated “it is this approach that the legislature has disavowed by making mediation mandatory.”
My comments about this decision were quoted in the recent edition of the Law Times Journal. The link to the article is:
When you think about car insurance, it probably makes you gag or fall asleep Seriously! Who wants to hear about things like deductibles, benefits, premiums or the Insurance Act. It’s all a bore.
Our government has made Ontario’s Car Insurance so dense, so thick, and so complicated that changes to the Insurance Act aren’t even made within the Insurance Act anymore. Instead, they’re made into separate “Schedules” which are completely different Acts in and of themselves Genious!
These “Schedules” are called the Statutory Accident Benefits Schedule or SABS for short. There are SABS for accidents on or after January 1, 1994. There are separate SABS for accidents on or after November 1996. There are separate SABS for accidents on or after December 2002. There are separate SABS for accidents on or after September 2010. Get the picture? Now who on earth has the time or the patience to go over this, know where to find the updated SABS or even understands what the SABS are trying to talk about. I can tell you this. They aren’t in plain to understand English that’s for sure. Try taking them to your local MPP and ask for their help in interpreting them. They’ll be as dumbfounded as you. But it’s the MPPs and our government who are the architects of the SABS…go figure…
Ontario has a very complicated accident benefits system for car accidents. Car accident lawyers have to keep up with the changes in the laws, which occur regularly.
If you or a loved one has been hurt or injured in a car accident, you are allowed to claim accident benefits. For some, the most important group of accident benefits are those relating to income, caregiver and non-earner benefits. All of these benefits represent money which is potentially available to you in the event that you are not able to lead a normal life as a result of your car accident.
The thing that insurance companies DO NOT tell you, is that you have the right to chose which benefits you would like. This is called an “election”, and there is a special form that you must complete in order to elect one of these three benefits. If you DO NOT elect one of these three benefits, then the insurance company will pick a benefit for you; and it will likely be a benefit which is advantageous for them, and not for you.
One of the most important things for an accident victim to understand when pursuing their personal injury case is how the laws of damages apply to their individual case. The laws of damages are very important, because at the end of the day, how damages work has a direct impact on how much compensation an accident victim will receive at the conclusion of their personal injury case.
One of the examples that we use to illustrate the importance of how the laws of damages impact personal injury cases, is providing the example of what if Superman were involved in a car accident?
One nice summer day Superman is crossing the street as a pedestrian on his way to the local library. Suddenly and without warning, a drunk truck driver runs a red light and crashes directly into Superman; while Superman is crossing on a green light in between a cross walk. The accident is clearly not Superman’s fault.
Many people who have been hurt or injured in an accident ask me why they should contact a lawyer. What will a lawyer do for me that I cannot do for myself?
The answer is simple. A personal injury lawyer will protect your rights to ensure that your claim is protected and to ensure that you are not taken advantage of by the insurance company opposite your claim.
For many, a traumatic accident such as a high speed car accident or bicycle accident represents the first time that they’ve experienced dealing with a serious personal injury claim. As a first time accident victim, you will not have any idea where to start.
Social networking sites like Facebook and Myspace have become increasingly popular over the years. People use these website to post information about themselves, post photos, even videos. These websites are intended to be a fun way to network and interact with others.
Accident victims who start legal actions often make claims that their lives have changed since their accident. People complain of constant pain, fatigue, depression, anxiety and being unable to enjoy their activities or their lives like they did before their accident.
Traditionally, insurance companies have requested mountains of documents and medical records to substantiate and confirm the accuracy of an accident victim’s personal injury claim. Insurance companies are now starting to look to less traditional avenues to get all the dirt they can on an accident victim’s claim.
Ontario Law requires that all car drivers carry valid automobile insurance. After you or a loved one have been involved in a car accident, you are required to report the accident to your insurance company, or to the insurance company of the driver who hit you, in the event that you were not driving at the time of the accident. In the event that you do not report the accident, you will not be entitled to what are called “accident benefits” and it may effect how much money you can recover if you chose to sue the driver who hit you.
After you’ve reported the accident to the insurance company, they will send you a package of forms. These forms are called “Accident Benefit” forms. These forms can be difficult to understand and to complete, particularly when English is not your first language. If the insurance company does not send you the forms, you can get them online at www.fsco.gov.on.ca.
The form which starts the whole process is called an “OCF-1 Application for Accident Benefits”. This is exactly what it says it is. It’s an application form for accident benefits. You are required to fill out basic information about your name, age, address, how the accident happened, your injuries, details about your employment, and/or childcare requirements. By filling out this form, you are telling your insurance company that you are claiming accident benefits from them.
Toronto Injury Lawyer Blog