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When assessing cases, both Plaintiffs and Defendants need to evaluate risk.

What are the chances of success and more importantly; what does success look like?

For an insurer Defendant, the ideal successful case will involve a quick and quiet dismissal of the action; with or without costs. The case is closed and the insurer does not have to pay.

For an injured Plaintiff, success can mean a lot of things. It can mean a finding of liability against a Defendant which signals to the Plaintiff that s/he was right. It can mean a declaration that the Plaintiff is disabled or entitled to benefits which also validates a Plaintiff.

But for most personal injury lawyers and insurance companies, what they really look at is the worth of the case on the best day scenario for a Plaintiff (or worst day for the Defendant).

Now these estimates can vary depending on the lens through which the case is assessed. But it’s equally important for Defendant insurers to have an honest assessment of their potential exposure on a case so that they can underwrite it properly. Just as it’s important for a Plaintiff to understand their best day, or worst day so that they can best assess their risk every step of the way in the litigation process.

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Changes in seasons means changes in behaviour and patterns. Now that we are experiencing some “warmer” weather; we are seeing more people out and about. And I use the term “warmer” rather loosely. We aren’t seeing negative temperatures anymore and there isn’t any snow, ice, or slush on the ground. Here are a few of the trends that we see in personal injury law as the temperatures begin to heat up.

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The majority of my clients are first time litigants:

  1. It’s their first time retaining a personal injury lawyer; or retaining a lawyer at all
  2. It’s their first time suing
  3. It’s their first experience with the legal system
  4. It’s their first time getting really hurt and needing to do something about it from a legal perspective
  5. It’s their first time getting denied by an insurance company
  6. It’s their first time feeling gaslit by an insurance company
  7. It’s their first time participating in sworn statements, an examination for discovery, medico-legal assessments, mediation, having surveillance conducted on them, Pre-Trial, Trial and all of the other things which go hand in hand with personal injury cases

The parties which my clients sue or seek benefits from are large and sophisticated insurance companies. This is not their first rodeo. They are well versed in the dark arts of litigation. Strategically defending lawsuits is what they do well.

Insurance companies know what they are up against. They are facing off against for the most part, unsophisticated accident victims who are hurt or injured. The Plaintiffs are new to litigation and all of the ups and downs which it presents. Insurance companies know how to say the right things because they have experience. Having their lawyers say “healing words” to appease a Plaintiff; or say all the right things to gloss over a terrible sequence of events is less expensive than paying out an award for damages.

An apology costs n0thing. Stating condolences for the loss of a loved one costs nothing as well.

But paying out of a claim costs the price of said claim.

There is a quantifiable economic difference between the two which insurance companies and their lawyers know all too well. Why pay out on a claim when you don’t have to? Why pay more on a case when you don’t have to? It makes financial sense. If an insurance company either liked your claim, or wanted to get you the compensation you deserve; you would have received that compensation by now.

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Do I have a personal injury case? You be the Judge.

Once upon a time there was woman who was walking in a public park.  It was winter and cold and icy. In the middle of the park stood a large snow covered hill. There was no visible path up the hill because it was covered in snow and ice. The hill had been used by children for tobogganing, but there was nobody tobogganing on that particular day.

There were signs along the hill from the City/Municipality stating “Hill and Paths not maintained in the Winter. Use at your own risk“.

The hill was both high, steep, snow covered and slippery. But it was also very tempting and mysterious for the woman in the park who was standing at the foot of the giant hill. What could be on top of the hill? What could be on the other side of the hill? Am I strong enough to climb the hill and make it all the way to the top? Do you think that I would set a record for being the first person to climb the hill in the winter? If I climbed the hill on my own, would I win a prize? Perhaps I would be on the news for climbing this glorious hill….

So many questions, so little time; and such a tempting hill.

The woman could not resist. Her curiosity got he best of her and she proceeded to climb the hill. Slowly but surely, she summited to the top of the hill. But when near the top of the hill she lost her footing and twisted her ankle. She was not able to walk properly for days and needed some physiotherapy.

Now the woman calls a personal injury lawyer and shared her story of the giant hill in the public park. She wanted to sue the hill and sue the City/Municipality for not making the hill safe for people to climb in the winter. She wants to sue the manufacturer of her boots for not making the sturdy enough for the climb atop the hill.

It begs the question: Do I have a personal injury case?

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There are serious misconceptions of how people get paid, or receive benefits after they’ve been seriously hurt or injured in an accident.

You’ve likely heard stories of insurance companies paying for an accident victim’s lost wages, treatment costs or even getting them a modified vehicle or modified home before their case even settles.

Some of these things might be true. Some of these things might be false.

At the end of the day, it’s this sort of misinformation which creates large scale confusion as to what benefits get paid, and what benefits don’t get paid before a case even settles.

Goldfinger Injury Lawyers would like to set the record straight with this instalment of the Toronto Injury Lawyer Blog.

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In March 2021 my daughter tested positive for COVID. She contracted it simply by going to school. She was asymptotic, but the positive test certainly impacted her mindset.

At the time she tested positive, Toronto Public Health had some pretty strict quarantine mandates for people who tested positive, or for people who had close connections with people who had tested positive. The result for my family amounted to a 31 day quarantine/isolation period. I have never been on home arrest, but I can imagine that was what it would feel like.

Earlier this week my son tested positive for COVID. I tested positive for COVID the same day.. Thankfully we are both doing fine in the circumstances. Raspy voice, cold like symptoms, body aches. Nothing terrible and we hope these symptoms don’t worsen.

For most parents with children under the age of 10; the most difficult thing about living with COVID isn’t the COVID itself. It’s having to watch and engage with the children while everyone is isolated at home. It sounds easy; but it isn’t; particularly after a long 2 years of on again, off again lockdowns. It hasn’t been the COVID that’s scared me. It’s the isolation and quarantine. While the quarantine times have shifted from 30 days, down to 15 days, down to 5 days; those days of quarantine add up and remain hard for parents with young children. There is only so much children can tolerate being on lock down inside of their homes. It’s not natural for kids or parents alike.

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Ontario is scheduled to drop most mask mandates by March 21, 2022. Whether or not this is the right move or not has nothing to do with being a personal injury lawyer; so I’ll just stay in my lane.

But, in creeping closer to this date we have seen an uptick of assault calls surfacing at our law firm. These assault claims are no uncommon, only we have seen more and more of them as the pandemic has dragged on.

It has become apparent to me that over the course of the pandemic we have forgotten how to interact with one another and share public spaces. It seems that more of us have a sense of entitlement, together with a disregard or a lack of respect for the safety and security in public places. In other words, we forgot how to share space and how to interact in public groups. This is something that will take time to re-learn. But, we will get there.

In the meantime, what do you do when a stranger assaults you? Do you have a personal injury case? And if so, how do you pursue that claim?

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Sometimes things which are presented to you sound too good to be true. This can ring true in the sale of insurance products; such as critical illness insurance. When things sound too good to be true, they should be looked at with skepticism.

Our law firm handles critical illness claims. Anyone can purchase a critical illness policy and receive coverage (provided that they are approved for said coverage). More often than not these policies are sold by independent insurance brokers/agents.

As with any industry, there are some excellent brokers/agents. And there are some less than excellent agents/brokers.

Ultimately selling insurance is largely a commission based business. The more policies which an insurance broker sells, the more money s/he will earn. That means there is a direct financial incentive for a broker to sell you a policy of insurance; whatever that policy might be.

Many people want to protect themselves in the event of injury, disability or illness. One of the ways of doing so is by purchasing a critical illness policy. Of all of the living policies, the critical illness policy is the equivalent to hitting the jackpot on the slots in Vegas. It’s a lump sum payout for a critical illness as defined by the policy. This is attractive for many consumers when comparing it to a disability policy which pays a monthly disability benefit which is subject to an all source offset and whereby the definition of disability changes at the two year mark. One lump sum from the insurance company sounds much better to most people. There is no need to worry about an on going multi year relationship with the insurance company. If all goes well the insured can receive his/her lump sum payout and move on with their lives. As oppose to a long term disability claim where the insured will be in a month to month relationship with the insurance company until the end of the claim (which can take many years to wrap up).

Critical illness policies are high risk, high reward policies which insurance companies don’t so easily pay out on. They will require substantial medical evidence in order to approve your claim. It’s not as easy to get approved as you will think.

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Goldfinger Injury Lawyers is reaching out to you to help those suffering in Ukraine.
We are contributing to an organization which is sending out humanitarian aid relief boxes to Ukraine called Meest. Here is a link to their website:
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The OCF-1 is the Application for Accident Benefits.

How do I get an OCF-1?

Getting an OCF-1 Application for Accident Benefits is very easy. You can download a copy here at from the website of the Financial Services Commission of Ontario. But most people get the OCF-1 from their car insurance company after a car accident.  The car insurer will send the OCF-1 Application for Accident Benefits to you by regular mail, courier or by email. You can also ask a personal injury lawyer for the OCF-1. Most personal injury lawyers have access to these forms; not that it’s anything special because these are public forms.

The only problem with getting the OCF-1 on your own (not from the car insurer) is that you won’t know your claim number, or the name and contact information of the insurance adjuster who is assigned to your claim. What you don’t want happening is submitting the OCF-1 to the car insurer only for it to “get lost” in the void of mail which car insurers receive everyday. If there is no claim number and no adjuster assigned, you would hope that a file gets opened. But more often than not what happens is that the claim gets put aside and a file does not get opened. This isn’t right, but this is what can and what often happens if there isn’t a claim number or an insurance adjuster assigned.

Can an insurer be penalized for this sort lack of attention to a file? Sure. But getting to the bottom of that could take months or years. In the meantime the accident victim is not receiving the benefits which s/he needs. Take a more practical approach to this. Ask for a claim number and get the name and contact information of the insurance adjuster. Send the OCF-1 to him/her by email, fax and registered mail so that you know the adjuster receives it. This way your claim will get moving forward and you will get the benefits you need in a timely manner (we hope).

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Toronto, ON M2N 1M9
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