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Personal Injury, Long Term Disability and Car Accident cases across Ontario are built upon EVIDENCE. Our legal system doesn’t play out in such a way as a Plaintiff makes a claim, yells a lot that they’re entitled to compensation, and then they get what they want. If Courts worked that way, those with the loudest voices would always win. In order for your case to succeed, you need evidence.

Evidence can’t be made up or fabricated. In order to be persuasive and carry weight, your evidence needs to be pure, legitimate, and not tampered with or altered.

Evidence comes in a lot of different forms. Evidence can be oral testimony from an examination for discovery. It can come from testimony at trial while a witness or party is on the stand. Oral evidence can come from parties to the litigation, witnesses to the action, lay persons/character witnesses, or experts.

Evidence can also come in the form of documentary evidence. Police reports, medical reports, video surveillance, 911 recordings, photos of injuries etc. All of these items are forms of evidence as well.

Cases are made and broken based on evidence. How much weight evidence is given depends on the Judge/Jury.

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Our law firm handles a wide array of personal injury and disability claims. Many of our cases are against large, multi-national insurance companies who provide all types of insurance coverage. One of the most common sort of claims we see are Short Term, and Long Term Disability claims against such companies as SunLife, Manulife, Great West Life, Industrial Alliance, Canada Life, Co-Operators, RBC Insurance, Desjardins, SSQ etc.

One of the biggest eye openers for our clients is what happens when they take a look at the fine print contained in their respective long term disability policies. After all nobody other than a personal injury lawyer uses an LTD Policy as their night time reading material.

These LTD policies are written by insurers, to minimize the potential exposure of an insurer; while giving the appearance that you’re getting amazing coverage. For most group and individual policies, you get what you pay for. The cheaper the policy, the cheaper the coverage. But even the best, and most iron clad policies are riddled with loop holes which may minimize your potential claim.

The purpose of this week’s edition of the Toronto Injury Lawyer Blog Post is to examine your run of the mill LTD Policy, and examine those provisions therein designed to limit your claim.

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A few weeks ago, the Marco Muzzo sentencing grabbed national headlines. In case you don’t know about the Marco Muzzo case; here’s the gist.

Mr. Muzzo was driving drunk in York Region. His drunk driving led to a fatal car crash which killed 4 people. It was a tragic collision. At our law firm, we don’t refer to these collisions as “accidents“. Accidents are by their very nature, unintentional acts. You mean no harm, although harm may come from your unintentional negligence.

Drunk driving on the other hand is never unintentional. It’s a conscious decision to drink, and then another conscious decision to drive. Every person needs to know or ought to know that whenever you get behind the wheel after you’ve had a drink or two puts the lives and safety of other motorists at risk.

Mr. Muzzo was sentenced to 10 years in prison. He received 8 months credit for time spent in prison pre-sentencing. That means that he will only need to serve 9 years and 4 months in jail. Upon release from prison, he will be prohibited from driving for 12 years.  He will be eligible for parole and an early release. When that time comes is up to the Court. In my informal poll of criminal lawyers, the consensus is that if Mr. Muzzo is a model prisoner, he may get parole in around 3 years or so.

Think about that long and hard. If Mr. Muzzo, having made a conscious decision to drink and drive and kill 4 people is out on parole in 3-4 years, does that punishment/penalty fit the crime? Conversely, does 9 years and 4 months of jail time fit the crime?

Finding the right balance between penalty, punishment, deterrent and rehabilitation/reintegration of an offender is a difficult balance. This is one of the hallmarks of Canada’s criminal justice system. The goal of the justice system is not only justice, but it’s to rehabilitate and reintegrate offenders so that they can become productive members to society.

This same delicate balancing act does NOT apply to the civil justice system. Nobody is doing jail time (unless they’re found in contempt of Court or in repeated breach of a Court Order) for having caused damage to others.

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When I first began practicing personal injury law, I quickly noticed how COMPLICATED Ontario’s regime of car accident law was. This was completely unnecessary.  Our government has made things so complicated, that lawyers need to focus on in car accident law in order to get results.

Car accident law should not be rocket science. In its purest sense, an innocent accident victim is seriously injured by another party who made a mistake or driving error. Rarely is there deliberate intent on the at fault party to cause a serious accident (save for drunk driving cases). There is no requirement for the parties involved to be sophisticated, knowledgeable of the law or wealthy. The at fault party should be responsible to compensate the injured party for the losses and pain and suffering. This sounds easy enough.

At Goldfinger Injury Lawyers, we have always engaged in making the law easy to understand for our clients. We want to break things down, so that people understand how things work, and how their case works.

This task has been made exponentially more difficult since April 1, 2016. The Ontario Government has moved all accident benefit disputes to a new Tribunal. New rules. New forms. More forms. More expensive to start the process for the injured. NO ACCESS TO THE COURT.

It used to be when you had a problem getting paid accident benefits, that you were able to apply for a FREE MEDIATION to the Financial Service Commission of Ontario (FSCO). FSCO was a Ontario Government body responsible for hearing all sort of accident benefit disputes between insurers and injured accident victims. There was a rich body of case law and detailed rules of procedure which had evolved. Insurers, paralegals, lawyers and even some members of the public knew how the system worked. There was familiarity. It was tailored specifically for accident benefit claims. And if matters didn’t pan out of FSCO, it was within the claimant’s power to keep pursuing the claim via Arbitration at FSCO, or leave FSCO entirely and sue instead before the Ontario Superior Court of Justice. There was a level of flexibility and control there which allowed the claimant to control the process to some extent. There were also many opportunities for settlement along the way.

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99% of personal injury cases in Ontario settle without ever going to trial; or without ever seeing the inside of a Courtroom for that matter.

The same cannot be said for criminal cases in Ontario. The government keeps stats on the percentage of criminal cases which go to trial. These stats are displayed on the Ontario Court of Justice website, and vary from month to month, depending on the offense.

There are a lot of lessons which can be learned when a high profile case such as the Ghomeshi case goes to trial. What happened in that downtown Toronto courtroom, isn’t dis-similar to what happens in other courtrooms across the Ontario. The primary difference is the amount of media attention which the Ghomeshi case garnered, and continues to attract.

What the personal injury lawyers at our office found so amazing, was the analysis and evidentiary principals applied in the highest profile sexual assault case we can think of; are VERY similar to the analysis and evidentiary principals which are applied in your run of the mill car accident, slip and fall, or long term disability case.

Our lawyers were also amazed at how many people chimed in on the findings of the decision of the Honourable Justice Horkins, without actually having read the transcripts from trial, read the Judge’s decision, or without having attended at Court in person to listen to the evidence presented.

Very quickly, if you haven’t read the decision from the Ghomeshi case, we urge you to do so. It will be a primer to how our legal system works and how our legal system weighs evidence. A link to the Ghomeshi decision can be found here.  Evidence is the building block to any case. Without evidence, our legal system doesn’t work.

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I was just visiting my local bank. All across the banker’s desk were glossy flyers advertising critical illness and mortgage insurance. Behind the banker’s desk, there was a lovely poster which again, promoted critical illness and mortgage insurance.

The promotional material paints a very nice picture of what critical illness and mortgage insurance can do for you; should things go terribly wrong.

 

The narrative went something like this:

“I was diagnosed with terrible cancer…Thank goodness I had critical illness insurance with (Insert Name of Bank/Insurer here). Thanks to (Insert Name of Bank/Insurer here) I was able pay off my debts and live with dignity”.

The photo featured a happy and smiling family. Other photos showed a person who appeared to have a very serious and worried look on their face. Either way, these advertisements really drew on the heart strings.

In theory, critical illness and mortgage insurance policies are fantastic. In theory that is. When you get diagnosed with a “critical illness“, or with a “disability“, then your insurer will automatically pay out a lump sum cash benefit. No questions asked. This sounds great; doesn’t it!?

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Dear Ontario Drivers:

I am writing to update you on recent legislative changes that affect your car accident claim; in particular your Accident Benefits claims with your own insurer. There are two sides to any car accident lawsuit; the Accident Benefits file with your own auto insurer, and the main action against the driver who caused the accident. The Accident Benefits file is meant to provide money up front to cover things like income replacement (in part) and treatment expenses. It is important to get everything you can from the Accident Benefits side of the law suit so that you can maximize your recovery and reduce the losses from the car accident. The changes to the law are on the Accident Benefits side.

As you may know, when your insurer refuses to pay for a benefit, you have the right to apply to the Financial Services Commission of Ontario (FSCO). The process starts off with a Mediation teleconference where we try to convince the insurer to pay. If that fails, we proceed to the next step, being the Arbitration, where an Arbitrator makes an official ruling as to your entitlement, or lack thereof, to the benefit in dispute. The insurance company has to pay a $3,000.00 fee towards the Arbitration – we only pay $100. The Arbitrators who decide on the issues are known to be quite fair and whenever there is an ambiguity in the law, they tend to interpret the rules in favor of the injured party. Furthermore, the Arbitrators’ decisions are binding on one another, so if an Arbitrator makes a general ruling about an issue, the insurance companies tend to accept it easier knowing that another Arbitrator will likely make the same ruling. For the above reasons, the FSCO process is an acceptable form of dispute resolution although it is far from perfect and there are often long delays before you get a decision.  Continue reading →

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The winds of change aren’t just blowing for car insurance in Ontario. They’re howling! Over the past 8 months, Ontario’s government has announced a major overhaul to how personal injury disputes arising from the use or operation of a motor vehicle are dealt with.

Why is this important to you?

For starters, if you drive a car, or a passenger in a car and sustain any sort of injury, then these changes will impact you. Secondly, it’s the LAW if you drive a car or motorcycle to have insurance. If you drive a motorized vehicle without insurance, then you’re breaking the law and you don’t want to do that. Because car insurance is a requirement, then it ought to be GOOD, and not a hollow policy.

In Ontario, we have a no fault system of accident benefits. These accident benefits are there to protect policy holders, like you and me. The intent of the accident benefit system and the surrounding legislation is CONSUMER PROTECTION LEGISLATION. We are getting away from that “Consumer Protection” part as each day goes by.

Here are some of the highlights from the drastic changes which will kick in effective April 1, 2016 and June 1, 2016:

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The stereotypical image of an injured accident victim in a personal injury case involves a person in a wheelchair, wearing a neck collar, with multiple casts on their legs and arms. Their lawyer is pushing the wheelchair from behind, in to a Court room, parading them before a Judge and Jury so that they can get an appreciation of their injuries.

Some paraplegia and quadriplegia accident victims are certainly like this. These case are no joke. But not every case is a involves paraplegia or quadriplegia.

In most cases, broken bones mend such that the injured accident victim is no longer in a cast at the time of their trial, hearing or mediation; which can take up to 5+ years to get to following a serious accident if things get delayed.

Most injuries are invisible to the judge, jury and insurance company. These might be scars under concealed clothing. Or they might be injuries to the brain, mind, psyche, emotions and cognitive abilities of the injured party. These injuries cannot be seen at first blush. But with some probing and some digging in to the medical evidence, they will come out with the assistance of a skilled lawyer by your side.

Following a serious accident, one of the first things which a lay person first notices are the physical injuries like the broken bones. What can get missed are those other invisible injuries I’ve just eluded to. Unlike broken bones, which can get better over time; these invisible psychological and cognitive injuries get worse and become more pronounced as time passes.

These invisible injuries often come on when somebody bumps their head, losses consciousness or sustains a concussion following a traumatic accident. The accident can be severe such that an MRI picks up spotting on the brain. Or it can be light such that the head simply whips back against the head rest causing a bad knock to the head whereby your mood and cognitive symptoms get worse over time. When these sort of injuries occur, lawyers are able to categorize them as brain injuries. All brain injuries are severe; although some are more pronounced than others. There is no magic pill to make a brain injury go away. There is no cast for the brain. No magical cream, balm, application or band aid to make the brain better. It’s a delicate organ in your body that can’t be replaced.

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Here’s the scenario:

You’ve been working diligently for the same employer, at the same job for years. You’ve given it your all. Countless hours of pain staking work. The job pays well. You have some great colleagues at work. And you have a benefits plan that you believe is fantastic. Part of that so called benefits package is disability insurance; which; in theory; you’ve been told will cover your wages if for whatever reason you can’t return to work on account of injury, illness or disability. You know little about the disability plan because you’ve never had to use it before and you’ve never missed out on work for a prolonged period of time. Your past work attendance has been excellent. Your performance reviews are always top notch.

And then; things happen to change. Some really bad luck. A fall here that never quite heals. You throw out your back on account of a minor slip and fall. Or perhaps chronic pain starts to take over your body such that you can no longer focus, get out of bed or function like you used to. Or maybe you just aren’t the same person any more on account of psychological illness like anxiety, depression, sadness or a combination thereof. Perhaps you’ve been diagnosed with chronic pain or fibromyalgia. Whatever the reason, disability happens. Unfortunately, it’s a part of life for many. And when disability happens, you would hope that your long term disability insurer and employer are both there to support you when you need the help the most. After all, you’re the all star employee who has given it his/her all over the past 10+ years at work.

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