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Long Term Disability Claims are NOT claims for pain and suffering.

Long Term Disability Claims are not based in negligence.

Nobody from long term disability insurer ran you over with a truck or hit you with a baseball bat resulting in your disability. You had something completely unrelated to your relationship with the long term disability insurer; before your disability arose. It could be serious medical condition; a bad slip and fall; or a stressful work environment. Nonetheless, the long term disability insurer had nothing to do with giving you the disability in the first place.

To be fair the way a long term disability insurer treats you can result in mental anguish, financial distress or harm. These sort of claims along with bad faith claims handling is a separate tort all together. These cases are the exception, but they certainly do happen.

But the foundation of a long term disability claim are the long term disability benefits themselves; which are a creatures of contract, not tort.

Standing alone from any separate tort or bad faith claim; quantifying the value of arrears and futures is a mathematical equation based in contract. It’s not an imaginary number which is made up by the Court.

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More people than ever have to attend Methadone Clinics to deal with their addiction and substatnce abuse issues. Opiate dependence and substance abuse issues are very real, and very costly on so many levels. They threaten to bottom out health care spending, take emotional tolls on families, loved ones and friends; and ruin lives.  Methadone Clinics are just one of the ways which Ontario is trying to deal with these problems. It will take a multi disciplinary approach to get a handle on addiction and substance abuse issues. But there can be no dispute that they are serious issues which our government and health care system are working very hard to resolve.

The focus of this edition of the Toronto Injury Lawyer Blog will be to examine what happens when there has been a prescription overdose; or a dispensing error at a Methadone Clinic in Ontario, or at a Pharmacy in Ontario. These cases are becoming more common with the increasing number of people who are prescribed and dependent on methadone to manage their problems. Pharmaceutical negligence and dispensing errors are not uncommon and can cause serious, life changing damages for which innocent claimants deserve fair compensation for their losses.

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“For the People“……

That’s what the Ford Government promised. That’s what the Ford Government was supposed to deliver.

They certainly aren’t delivering on any front.

Another promise made. Another promise broken I suppose.

Let’s examine this “For The People” government from the personal injury corner of there room.

Bill 118, Occupiers’ Liability Amendment Act, 2020 came into force on January 26, 2021. Right in the middle of the Pandemic because nothing says Global Pandemic quite like amending the Occupiers’ Liability Act for slip and fall cases in the middle of the winter!

The Explanatory Note of that Act clearly states:

“The Bill amends the Occupiers’ Liability Act to provide that no action shall be brought for the recovery of damages for personal injury caused by snow or ice against an occupier or an independent contractor employed by the occupier to remove snow or ice, unless, within 60 days after the occurrence of the injury, written notice of the claim is served.”

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If you haven’t heard of what a COVID Long Hauler is, you should look it up. As a personal injury and long term disability lawyer, I don’t profess to be a medical expert. This is where I defer to the doctors have to say about COVID long haulers and the potential long lasting health implications by those who study COVID at the Mayo Clinic , Harvard Medical School and the Cleveland Clinic.

Tens of thousands of people who have contracted COVID, have been left with lingering symptoms and effects including but not limited to fatigue, body aches, joint pain, coughing, shortness of breath, difficulty concentrating, inability to exercise, loss of taste or smell, headaches, and difficulty sleeping. COVID Long Haulers can’t exert themselves or exercise and simple tasks (like walking to the mailbox or taking out the trash) will often leave them feeling exhausted. Chronic fatigue and chronic pain as being reported with COVID Long Haulers can be incredibly debilitating and frustrating. Many long-haulers also report brain fog, difficultly concentrating or feel like they aren’t as sharp as they used to be.

The reality of COVID is that it’s a new disease which began in an outbreak in around December 2019. Given the newness of the disease, doctors have little data to know the the long term effects or recovery from these long term effects/symptoms. Only time will tell. The vast majority of COVID Long Haulers test negative for COVID after the first few weeks of contracting the disease, despite still having these COVID long haul symptoms.

Long-haulers include two groups of people affected by the COVID:

  • Those who experience some permanent damage to their lungs, heart, kidneys, or brain that may affect their ability to function.
  • Those who continue to experience debilitating symptoms despite no detectable damage to these organs.

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If you’ve sustained serious and permanent injuries in car accident, you recover damages against the at fault driver.

Standard policy limits in Ontario sit at $1,000,000. Ontarians can purchase optional benefits to increase their coverage, but only few ever pick up that option (mostly personal injury lawyers, insurance adjusters, insurance brokers and insurance defence lawyers…notice a trend…mostly people in the know).

In some cases, those policy limits are greater than $1,000,000. Often commercial carriers have policy limits of $5,000,000 or greater. Sometimes your car insurance combines with your home insurance creating what’s called an umbrella policy or umbrella coverage, thereby increasing the policy limits from $1,000,000 to $2,000,000 in coverage.

It’s a good thing for an injured accident victim when there are greater policy limits. It means that the injured party will realistically be able to recover more damages in their personal injury case, if they are entitled to those damages at law.

To understand this concept of recovery, let’s examine what happens when policy limits are inadequate to satisfy a claim.

Let’s say that the claim is worth $1,500,000, but there are is only a $1,000,000 limit under the policy. The first $1,000,000 will be covered by the insurance company pursuant to the insurance policy. This leaves a shortfall for the claim of $500,000.

It will be Defendant’s personal responsibility to cover this $500,000 shortfall in the event they don’t have a policy which will cover the excess amount owing. This $500,000 is not insurable under the standard car insurance policy. The Plaintiff can secure a judgment against the Defendant personally and seize or lien his/her assets; or even garnish his/her wages until the Judgment is satisfied. Please note that Ontario Works payments are NOT subject to garnishment. What is however subject to garnishment are regular pay cheques/wages.

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Has someone other than you driven your car without your knowledge?

What happens if that mystery person gets in to a car accident?

What happens if you knowingly loan your vehicle to someone else to drive; and that person gets in to a car accident; but it turns out that the driver was operating your vehicle without a driver’s license or with a suspended driver’s license?

What happens if you loan your vehicle to a driver who was specified as an excluded driver under the policy?

While these hypothetical fact patterns may seem a bit remote, or foolish, they happen more than you think!

Cases such as these often see their way up the the Court of Appeal, or try to get heard at the Supreme Court. Leave to appeal is sometimes granted, and sometimes denied. Nonetheless, these coverage issues do not stop the parties from trying to get their cases heard before the Supreme Court. These cases drive the law in one direction or another. Often large insurers will spend a disproportionate amount of money arguing these coverage claims given that they will impact present and future coverage disputes. What this means is if on the face of the claim, the parties agree that the damages would range between $40,000-$100,000; insurers will spend that money if not more arguing the disputes. These are business decisions based upon legal principals in order to get the law right. And when I mean right, I mean working in favour of an insurer to deny coverage and not the other way around.

The grand lesson from all of these hypotheticals and decisions is that it’s very important to know who you are loaning your car to, and to know whether or not that person is allowed to legally drive. If not, you could end up in the wrong without coverage.

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Lock Down Life has been no fun for anyone. Regardless of your socio-economic background, political views, or religious beliefs, this Pandemic has been difficult for everyone for so many reasons. Unless that is if you’re a high profile cabinet minister taking some time off for a vacation to St. Bart’s. Sounds nice. If only we could all be Minister of Finance and depart for St. Bart’s in the midst of a global pandemic where non-essential travel is barred.

Speaking of non-essential travel, our new favourite website during the Pandemic has been the Arrivals log on the Pearson International Airport website. 

Why, just today, international flights have come in from all over the world including Istanbul Turkey; London UK; Shanghai China via Seoul Korea; Toucumen Panama; Lisbon Portugal; too may American cities to mention, along with multiple other domestic arrivals. Not to mention the departures to such exotic locations as Mexico City, Mexico; Doha Qatar; Sao Paolo, Brazil; New Delhi India; Lima Peru and the list goes on. But you need not worry. We’ve all been promised that none of these people flying have COVID, and all travellers pinky promise to quarantine for 7-14 days depending on who you ask as it’s clear as mud. While all of these travel plans go on to this day, Ontarians are on a strict lock down such that they can only leave their homes for essential purposes, but you are kinda free to fly wherever you like. And if you’re a politician who makes up the rules for masses, then these restrictions are completely arbitrary and likely don’t apply to you. Go figure. The Government “For The People” continues to be the most ironic term ever. More like Government for Me (and by “Me” I’m referring to the political ruling class and their buddies; everyone else really doesn’t matter).

As a personal injury lawyer, we’ve seen a lot of changes to behaviour during the Pandemic. The purpose of this Toronto Injury Lawyer is to examine those Pandemic trends which have really made us shake our heads.

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The clashes taking place in Washington DC earlier today got me thinking about assault cases. It’s a mess what’s happening there.

We have seen a spike in calls during the pandemic with regard to physical violence. I can tell you there’s a lot of rage inside and outside homes. People are fed up of being locked down and are either taking matters in to their own hands, or taking out their frustrations on other people (family and strangers a like).

Goldfinger Injury Lawyers certainly doesn’t endorse the use of violence. Victims of violence often call our law firm to get the compensation which the deserve.

The problem however with these types of assault cases is recovering money on behalf of our clients. This is a very common problem in assault cases and I will share with you why in today’s instalment of the Toronto Injury Lawyer Blog.

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Long Term Disability cases are at their essence, contract cases.

In a long term disability case, there is a contract of insurance between the Plaintiff and the Defendant. The contract is between the Defendant insurance company (Great West Life, Canada Life, Manulife, Sun Life, Empire Life, Desjardins Insurance, SSQ Insurance, Co-Operators Insurance, RBC Insurance, La Capitale Insurance etc.) and the Plaintiff policy holder.

A car accident case for pain and suffering or a dog bite case is very different because there is no contract between the Plaintiff accident victim and the at fault party. These are straight tort cases. Accident benefit cases for first party insurance are certainly different, but the legal principal is the same given that the cause of action for tort cases is not contractural. In both car accident and dog bite cases the cause of action is in negligence against the at fault party.

The policy holder can be a company which covers all of its employees (a group policy through your employer), or it can be an individual policy of insurance.

In the case of an individual policy of insurance, the policy holder goes out and purchases the insurance on their own either directly through the insurance company, or through an insurance broker. The insurance broker may sell a variety of different policies underwritten by a variety of different companies. Variety is the spice of life, so getting options to purchase your insurance is a good thing. That way the consumer can compare and contrast prices, definitions, exclusions and benefits between polices. Having a good and knowledgable insurance broker is very helpful when comparing and contrasting long term disability policies.

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We made it. Post # 500!!!!

It’s one thing to prepare posts of few words. But we’ve been pretty consistent here at the Toronto Injury Lawyer Blog. Each post has on average 1,000 words.

So 500,000 words later, do we have any greater insight than when we first began? Do we have any new words of wisdom for those trying to prepare a successful legal blog?

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