Articles Posted in Insurance

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Today Ontario’s Court of Appeal released a landmark decision in Hurst v. Aviva. This decision has an impact on ANYBODY who has been hurt or injured in an accident in Ontario. It relates specifically to accident benefit law, which is a complicated, man made set of laws which gets tweaked every year by the provincial government.

This decision confirms that accident victims deserve timely access to justice when they have a dispute with their own auto insurer over statutory accident benefits.

So, what’s this case all about and why’s it so important? Keep reading and I’ll fill you in!
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As a personal injury lawyer, I get calls all the time from people insisting….swearing….preaching….advocating…yelling at me that they have an AMAZING case that’s so clear cut, only a foolish lawyer would turn the case down.

I often get these sort of calls on long term disabilty cases, and critical illness insurance cases. In case you don’t know, long term disability insurance (LTD) and crintical illness insurance (CI) are both products which you can purchase on your own from a broker, or are benefits through your employer which are to protect you in the event you can no longer work at your own occupation; or in the event you’ve sustained a critical illness such as cancer, or a heart attack. In the case of long term disability insurance, you will recieve a monthly premium which can reflect 75% of your net pre-disability earnings (a monthly benefit). In the case of critical illness insurance, you can recieve a lump sum of up to $1,000,000 depending on how your policy is structured. But, let’s continue on with the stories of those phone calls from people swearing to me that their case is a SURE BET.
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Last week the Toronto Injury Lawyer Blog was in the midst of providing you with valuable tips to complete the OCF-1 Application for Accident Benefits. Now, we’re going to complete this topic on how to properly complete the OCF-1 following a car accident. The fact that it will take 2 (or 3) blog posts to properly complete this topic without rendering you the reader into a coma (likewise to yours truly the writer), should be an indication to you how technical and tedious these forms are to complete.

For your refernce, the OCF-1 Application for Accident Benefits Form can be found on the website of the Financial Services Commission of Ontario here; or at the Goldfinger Injury Lawyers Website in the Accident Benefits section here.
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Today I watched a great clip from Howard Elmer, a contributor to my favourite car television show; MOTORING TV. Motoring TV is on TSN and its a great show about cars, and the people who drive them.

In this clip, Elmer describes how the Insurance Industry is trying to again cap your benefits because the cost of insurance in Ontario is simply too high. There’s also talk about insurance fraud. But, based on my experience, the fraud you see if far less than insurers insist exists, and is a GTA phenomenon. If have yet to see any sort of frauds outside the GTA (Toronto, Vaughan, Mississauga, Brampton). I have yet to sniff or even suspect auto insurance fraud akin to what might exist in Toronto. In any event, this is a great video clip. Here’s the link to the clip. I couldn’t have said it any better myself. Well done Howard.
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Want to learn about the importance of completing an OCF-3 Disability Certificate after your Toronto car accident? Read on.

The OCF-3 Disability Certificate is a form created by the Financial Services Commission of Ontario. Why they created this, along with other silly forms is still a mystery to me, along with personal injury lawyers across Ontario. It all has to do with Ontario’s complicated no-fault accident benefit regime, but that’s the subject of another post.

In any event, following your car accident, your insurance company will send you a booklet of forms. And when I mean booklet of forms, I really mean it. If you don’t like reading, or you don’t like completing standard forms which require a lawyer to understand, then you’ll certainly have issues with these forms. One of the forms is called the OCF-3 Disability Certificate. This is probably the most important and telling form for you to have completed.
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It’s astonishing the number of car accident victims in personal injury cases who come to my law firm unprepared for some of the questions I have to ask them. Basic things like:

1. When did your car accident happen?
2. Do you recall the time of day when the car accident took place?
3. Who was in the car with you at the time of the car accident?
4. Do you recall if the police attended at the car accident scene?
5. Do you recall if an ambulance came to the site of the car accident?

For some people, these questions are difficult to answer, if not impossible due to a brain injury, or the catastrophic nature of their injuries. Some people are unable to communicate given their injuries, or have post traumatic amnesia following their car accident. We see it all the time.
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Ontario’s Court of Appeal released a landmark car accident decision yesterday in the case of Pastore v. Aviva.

The decision deals with the definition of “catastrophic” under Ontario’s Insurance Act.

60 year old Toronto resident Anna Pastore was attending a wedding when she was hit by a car back in 2002.(Editorial Note: this is a 2002 accident which is only getting resolved yesterday 2012!!!! Is that nuts or is it just me. Talk about delay in our Courts, but that’s no secret to anyone.)

At the time of the car accident she was the primary caregiver for her husband who was very sick. As a result of the accident, she broke her ankle and later required knee replacement surgery. Her personal injury lawyer applied to Aviva for catastrophic benefits under the insurance Act.
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Fibromyalgia doesn’t exist! It’s a figment of your imagination! Get over it! Get outta bed and get a job! Excercise. Deal with your so called “pain“. Stop being depressed! Stop being sad right now! Be happy and pain free immediately you faker!

This is what insurance companies would love to tell all claimants who have used Fibromyalgia as the primary reason for their inability to return to work, or pursue any form of gainful employment.

Some doctors, particularly those old school doctors would tend to agree.

Other doctors, and this Toronto Personal Injury Lawyer would adamantly disagree. Fibromyalgia is real. Fibromyalgia is debilitating. Fibromyalgia is not a figment of your imagination. Our personal injury law firm has helped countless Fibromyalgia sufferers with their denied short and long term disability claims.
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People always ask me: Brian; I’ve been hurt in a car accident and now I can’t work. How am I going to pay my bills? How am I going to get by?

Great questions. Completely legitimate concerns. We here at Goldfinger Injury Lawyers recognize that if you’re name isn’t Sheikh Khalifa bin Zayed al-Nahayan (net worth 15 billion and the world’s wealthiest Sheikh), chances are that money is a big concern following a devastating car accident. HH-SHEIKH-KHALIFA-BIN-ZAYED-AL-NAHYAN.jpg

But first, I’d like to take a moment to recognize all the great emails I’ve been getting from my blog followers. My cousin Natalie formerly of Toronto, now of Florence by way of Los Angeles writes:
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One of the perks of any job can be the benefits. Such benefits can include money for a massage for relief after a stressful day, or for relief following a car accident. If you need a masseuse in the 905, seek out Lucas Jacobs RMT; he has magic hands.

Another perk can be the disability benefits; whether they be short or long term. Short term and long term disability benefits are often administered by separate third party insurers, such as Manulife, Great West Life, Standard Life, SunLife, Industrial Alliance, SSQ or even RBC Insurance. All of these insurance companies are known for processing, adjudicating, and administering short and long term disability claims.
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