COVID-19 Update: How We Are Serving and Protecting Our Clients

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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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I was talking to my father about the Ottawa Freedom Convoy Protests and what to do about them. This was before PM Trudeau announced the that his government would be implementing the *Emergencies Act and before the police finally did some real police work and cleared out most of the trucks and protesters.

*Note: Canada was NOT facing a National Emergency when PM Trudeau accounced that his government would be implementing the Emergencies Act. The protests at the border crossings in Coutts Alberta and Windsor Ontario had long been cleared up. While there were smaller protests happening sporadically across Canada; these protests did not amount to a NATIONAL EMERGENCY. The protests in Ottawa amounted to a localized emergency isolated to a few blocks of downtown Ottawa. While these protests may (or may not) have presented real or potential security issues; these were localized issues which the municipal police and provincial police ought to have dealt with. But they had a really hard time dealing with them for reasons that I, nor will many Canadians really understand. Did they not see this coming!?!?!?!?! Had they not seen a protest before? Why were they so unprepared and so unwilling to act? How is it that the G-20 Toronto protests, Black Lives Matters protests and any Indigenous protests (BC, Belleville, near any pipeline) get cleared up so quickly by police (often using force), yet for this protest it seemed like authorities rolled out the red carpet to the protesters? But that’s a topic for another day, perhaps from a Civil Rights Lawyer.

Back to the topic of what amounts to be a National Emergency and whether or not the Ottawa Truck Protest qualified as such. The definition of “National Emergency” under the Emergencies Act is as follows:

National emergency

 For the purposes of this Act, a national emergency is an urgent and critical situation of a temporary nature that

  • (a) seriously endangers the lives, health or safety of Canadians and is of such proportions or nature as to exceed the capacity or authority of a province to deal with it, or

  • (b) seriously threatens the ability of the Government of Canada to preserve the sovereignty, security and territorial integrity of Canada

and that cannot be effectively dealt with under any other law of Canada.

The Ottawa Police Service and the Ontario Provincial Police ought to have been able to deal with this situation without the implementation of the Emergencies Act. Implementing the Emergencies Act should only be done when facing a real National Emergency. While it’s embarrassing that the capital city of a G7 nation can be blockaded by a few trucks, this is not a National Emergency. This is a time for the Ottawa Police, the OPP and the National Capital Commission to reflect on the lack of preparedness, lack of urgency and lack of security in Ottawa. It should have never reached a point whereby Ottawa was blockaded for 3 weeks. But I digress back to topics as they relate to personal injury law and car insurance to keep things on point.

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A well respected personal injury mediator recently compared a successful mediation to baking. It takes great ingredients to bake a great cake. The same as it takes a lot of different pieces of evidence and factors to make for a successful case or mediation. Just as one ingredient cannot make a cake. One piece of evidence or factor cannot make for a great case or mediation.

I love that analogy on so many levels.

Firstly, I like great cake. Who doesn’t? Yum!

Second: he is absolutely right. It takes great a lot of evidence to make for a great case. As it takes the parties working in harmony to get to “Yes” during the mediation process. Getting the ingredients right is required to get the deal done.

Finally and most importantly; the analogy which the mediator used (comparing needing great ingredients to bake a great cake to a successful case or mediation) is simple and easy for anyone to understand. I’ve found that easy to understand and easy to relate to analogies work best with accident victims. All too frequently lawyers and other actors in the personal injury litigation system forget that Plaintiffs haven’t done this sort of thing before.

In all likelihood it’s their first time hiring a litigation lawyer; it’s their first time suing; it’s their first time being exposed to the underbelly of personal injury litigation in Ontario; it’s their first time hearing legal terms that lawyers throw around.

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Many clients and prospective clients want to know where they should go for treatment after a serious car accident in Ontario.

It’s a common question because there are so many options and there is no “right way” of doing it. But there is certainly a wrong way of getting treatment.

For starters, there is no substitute for seeing your family doctor, or any other doctor for that matter who is covered by OHIP. These doctors are free and have no vested interest in your personal injury case. All they want to do is see that you get better and get the treatment you need. There’s nothing wrong with that.

Where people go wrong is that they leave their family doctor (or nurse practitioner) out of the picture when it comes to their post accident wellness and rehabilitation. Your family doctor is probably THE MOST IMPORTANT person when it comes to getting the treatment you need.

Lawyers and Judges rely heavily on the clinical notes and records of your family doctor.

Your family doctor can prescribe you with medication to get better. Your family doctor can make referrals to other specialists to help you recover. Your family doctor can request an x-ray, CT Scan, MRI or refer you to a pain clinic or brain injury program (all covered by OHIP). These are indicators to lawyers and to insurers that a Plaintiff is in pain and that something has gone wrong. If those diagnostic tests come back with objective evidence of a serious injury then it’s very hard for an insurer to refute that nothing is wrong with that Plaintiff. The doctor will know what’s wrong with his/her patient so that the patient can get the treatment which s/he needs. Don’t leave your family doctor or nurse practitioner out of the loop. A physiotherapist, occupational therapist, naturopath, chiropractor or social worker is NO SUBSTITUTE for your family doctor or nurse practitioner.

If you don’t have a family doctor or nurse practitioner, don’t fret. Get on a waitlist. These waitlists clear up faster than you would think. While you’re waiting, go to a Walk In Clinic or to your local Urgent Care or Emergency Department for check ups or for pain management. If you go to the same Walk In Clinic with frequency, they will get a sense of what you’re going through. It will be reflected in the records. Walk In Clinic doctors can make the same referrals and prescribe the same medication as a treating family doctor. If you have a health card, then you have access to a walk in clinic or urgent care clinic.

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If you asked personal injury lawyer what are some of the most common issues they face with car accident cases in Ontario; without a doubt the issue of the threshold and the deductible will be very high on their lists. Likely the number 1 issue which personal injury lawyers face for car accident cases in Ontario.

What are the threshold and the deductible?

Good question, because so few people know what they are, or how they work.

Let’s start with the deductible, because that’s the most concrete of the two concepts. The deductible acts as a secret credit which the insurance company doesn’t want you or the general public to know about. For every pain and suffering case involving a car or motor vehicle; the insurance company which acts for the Defendant is entitled to a LARGE CREDIT for pain and suffering award which falls below $138,343.86. The deductible for 2022 sits at $41,503.50. It’s the $41,503.50 elephant in the room for any car accident case. This means that if a Judge and Jury award an injured Plaintiff $50,000; after the $41,503.50 deductible is applied; it leaves the injured Plaintiff with only $8,496.50 in their pocket. This seems unfair. But that’s the law in Ontario.

The at fault driver could have been drunk, ran a stop light, while texting on his/her cell phone. The extent of fault will not matter. The deductible applies nonetheless regardless of fault.

It would appear that Ontario’s system affords the at fault Defendant with a $41,503.50 security blanket for each car accident. And that $41,503.50 security blanket only grows larger with time. The reason for this is that $41,503.50 figure increases each year with inflation. The deductible sat at $39,754.31 in 2021 and grew to $41,503.50 in 2022. Where will it be in 2030? Near $50,000? Near $55,000? It will only go up. I am not aware of any provision in the legislation which permits for deflation of the deductible. Only inflation.

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BRR!

It’s cold in out here
There must be a slip and fall
In the atmosphere

BRR!

It’s cold out here
There must be some slippy ice
In the atmosphere

Snow and Ice? Bring it on!

Snow and ice isn’t going to stop you from living your life. But, it can sure making getting around much harder, and more treacherous. We’ve seen some serious cold snaps and snow fall throughout Ontario. This has resulted in slipper winter weather conditions for motorists, cyclists and pedestrians.

The focus of this edition of the Toronto Injury Lawyer Blog will be what personal injury lawyers, insurers and Courts look for when assessing the merits and the value of a slip and call case in Ontario.

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The CBC Reported last month that nearly 58 pedestrians died as a result of car accidents on Toronto’s streets last year; with another 183 more reported as being seriously injured.

This is an alarming statistic given that 2021 was a year that saw rolling lockdowns due to the COVID-19 Pandemic resulting in fewer motorists on the road. Fewer drivers on the road resulted in fewer car accident claims. This trend was reported across Canada and in the United States where insurers saw large windfall profits on auto related insurance products. The savings have not been passed along to the consumer in the form of reduced car insurance premiums, but that’s a story for another edition of the Toronto Injury Lawyer Blog.

The City of Toronto has implemented a bold Vision Zero pledge to reduce the number of auto-pedestrian fatalities and serious injuries down to Zero. It’s a great goal, but since the Vision Zero program was announced, those fatality and serious injury cases to pedestrians have continued to steadily creep up.

Why is that?

Is the City not trying hard enough?

Are Toronto and GTA drivers simply the worst in the free world incapable of hitting pedestrians while driving?

Does it have something to do with the way Toronto’s streets are designed?

What can possibly explain why pedestrian fatality cases are so high in Toronto and the GTA?

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Marshall McCluhan coined the term “the medium is the message“.

This means in plain terms, without introducing a PHD thesis on the issue, that chosen method of communication to broadcast a message has a significant impact on how the message is received and understood. It’s almost to say that the way that the message is communicated (print, tweet, TV broadcast, radio), is just as important as the content of the message itself.

This notion that “the medium is the message” is very important when considering the impact which COVID-19 has played on our Courts and how personal injury claims are being litigated today.

This first struck me in the early days of COVID, after my first virtual discovery and my first virtual mediation. I had not done a virtual discovery, or a virtual mediation prior to COVID. Virtual proceedings were the exception and not the rule. It was expected that lawyers and their clients would meet in person for these earmark events in a personal injury case. Sometimes, an insurance adjuster would not be able to attend in person. They would be available over the phone. This was frowned upon because everyone was expected to be there; particularly for a mediation. But sometimes unfortunate life events would happen which prevented an in person attendance. We would proceed nonetheless and hope for the best.

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This edition of the Toronto Injury Lawyer Blog is coming out a bit early because I have the time to write now before I have to start homeschooling my children given the recent announced lockdown measures in Ontario. It’s rather difficult being a lawyer and educator for your young children at the same time. There’s a reason why kids go to school and aren’t taught at home by their parents who have full time careers.

I don’t need to tell you that Ontario is all messed up right now. Just tune into the news and it’s all doom, gloom, lockdowns and restrictions. It’s enough to make one cringe.

I’m just a personal injury lawyer, so it’s not my lane to comment on the health and safety of Ontario’s population. But what I can tell you is that I’m an optimist and I strongly believe that we will get through this. There is light at the end of the tunnel. This is the storm before the calm. If were were able to get through the Black Plague and Spanish Flu with nothing more than rubbing alcohol, spoonfuls of castor oil, other whacky home remedies and bandanas for face coverings; I think we will be able to get through COVID and all of its variations. What scientific belief is all of this optimism founded upon you ask? NONE! Just the fighting spirit of humankind and a positive belief that we all want the same thing which is for our health, happiness and our basic human freedoms.

A topic that is within my education, training and expertise is the area of personal injury law. This is the field of law I’ve been practicing in for basically my entire legal career.

Ontario has a really complicated system of car insurance. Each car accident case has two cases. The first case is a no fault accident benefit case with your own car insurer. Regardless of fault, the first claim is with your OWN CAR INSURER for accident benefits. These accident benefits cover such things as med/rehab benefits for physio, massage, chiropractic care, psychological counselling and anything else under the sun not covered by OHIP for your wellness and rehabilitation which is deemed to be both reasonable and necessary. Accident benefits also cover an income replacement benefit which under a standard policy of insurance is up to $400/week; and non-earner benefits for those unemployed or retired people of up to $185/week for up to two years; along with an attendant care benefit of up to $3,000/month for non catatrophic claims; which is then increased to up to $6,000/month for catastrophic claims.

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Not every case is perfect. That’s the reality of the law. Each case has its strengths, and weaknesses. Each case has its own unique set of warts so to say.

Some of these weaknesses can be avoided. Some of these warts can be treated.

As personal injury lawyers, we see clients make mistakes all the time; and that’s ok. Nobody is perfect. But the reality is that many mistakes can be avoided if people understand how the law works; and has a grasp of the consequences of their own actions; or lack thereof.

So without further a due, we will examine the top mistakes which personal injury clients conduct in the course of their accident and long term disability cases. It’s our hope that by understanding some of these mistakes, that personal injury claimants will prevent them from happening to strengthen their claims so they can get the compensation which they deserve.

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