Toronto Injury Lawyer Blog

Published on: June 12, 2025

Long Term Disability Denials

You know when you’ve been approved for Long Term Disability Benefits. That approval will usually come first verbally, and then be formalized in writing.

While, getting something in writing from the long term disability insurer might feel good, it doesn’t mean anything until the payments start coming in.

That rings true in real world examples:

Let’s say you hear from your adjuster that benefits have been approved. Great!

Then, you receive a letter from the insurance company which formalizes the approval in writing. Great again!

But, as Jerry McGuire would say “Show me the Money“.

When the insurer does examines your file, looks at how much money you made, and how much money you’ve received from other collateral sources, it turns out that the benefit owing to you amounts to ZERO! That means that the long term disability insurer’s approval amounts to no tangible benefits for you; even though you’ve been approved. The reality is that you’ve been approved for nothing!

In that same example, it might be that the insurer had been paying you long term disability benefits. Then, they stopped because you received collateral benefits (like CPP Disability Benefits). Then, having reviewed your file, along with the amounts paid to you in long term disability benefits vs. the amounts paid to you in CPP Disability benefits; it turns out that the long term disability insurer over paid you. Now, they are seeking a repayment of benefits due to the over payment. This means that you owe the long term disability insurer money. Imagine that: a person owing an insurance company money for a over payment (completely unrelated to payments of insurance premiums).

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Published on: June 5, 2025

Why insurance companies LOVE Jury Trials in Personal Injury Cases

By Goldfinger Injury Lawyers

Insurance companies love jury trials for personal injury cases.

But getting a trial by way of Jury trial is not automatic. The default is that the personal injury trial proceed by way of Judge alone. Having a personal injury case heard by way of Judge alone simplifies the trial itself. It’s less complex. Less lengthy. Takes up fewer Court resources. It’s cheaper, more efficient and more cost effective. How many times have you heard of a mistrial involving a Jury case because of some shenanigans involving the jury itself? Lots! Now; how many times have you heard of a mistrial by way of Judge alone? Not many! That’s because when the trial proceeds by way of Judge alone, there are fewer changes at disaster happening. These are undeniable truths.

A personal injury case which is proceeding by way of Judge alone can quickly be converted to a Jury trial if either party files a “Jury Notice”. The cost for filing a Jury Notice in a personal injury case is only $138. Insurance companies file Jury Notices as a knee jerk response to defending claims. And, all for the low, low price of $138, the framework of the case has been changed completely.

Why do insurance companies want personal injury cases to be tried by a Jury, and not by way of Judge alone? Good question!

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Published on: May 29, 2025

Brian Goldfinger and the Case of the Critical Illness Policy

By Goldfinger Injury Lawyers

Critical Illness sounds like a great deal.

If you purchase a Critical Illness Policy of insurance, and you get diagnosed with any of the illnesses identified under the policy, you get paid a great big lump sum of cash.

Depending on the policy and the premiums you get paid, that lump sum could be $100,000; $250,000, $500,000 or even $1,000,000 or greater.

Sounds too good to be true; right?

But beware. Things aren’t always as they appear. When things sound too good to be true, that’s often because they are.

Critical Illness policies are marketed in such a way to seem like they are a safety net should things go wrong. And sometimes, things go really wrong and the policies pay out. But, in my experience, more often than not, insurers find a way to get out of paying benefits.

I call it a bait and switch.

What do I mean by that? Let’s take a look.

Insurers cleverly market these policies as an affordable means to get coverage. They are “living policies”. That means that the recipient of the benefits is generally alive in order to recover benefits. These policies aren’t life insurance. Nor are they disability insurance. One of the triggering events needs to happen, and the person must survive the triggering event.

Those illnesses, or triggering events can be plentiful. They are marketed in a broad based way, like “cancer” is covered. The insurer doesn’t into great detail about the sort of cancer, or the severity or stage of the cancer. They simply market the coverage as for cancer. Or a heart attack. Broad and general terms are first used to lure a customer in. And that luring is very tempting. Cancer and heart attacks are quite common. So, buying insurance to cover such claims makes sense on first review.

Here are a few other common critical illnesses which are marketed to consumers in broad terms:

Cancer

Cancer of specified severity

Heart Conditions

Aortic surgery
Cardiomyopathy
Coronary artery bypass surgery
Heart attack
Heart valve replacement or repair

Neurological Conditions

Stroke
Acquired brain injury
Bacterial meningitis
Benign brain tumor
Coma
Dementia, including Alzheimer’s Disease
Motor neuron disease (incl. ALS)
Parkinson’s Disease and specified atypical Parkinsonian disorders
Paralysis

Autoimmune Conditions

Aplastic anaemia
Multiple sclerosis
Occupational HIV infection

Sensory & Mobility Conditions

Blindness
Deafness
Loss of limbs
Loss of speech
Loss of independent existence
Severe burns

Transplants & Organ-Related Conditions

Kidney failure
Major organ transplant
Major organ failure on waiting list

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Published on: May 22, 2025

HBC Bankruptcy and Long Term Disability Benefits

By Goldfinger Injury Lawyers

After hearing the news that long time retailer Hudson’s Bay Company declared bankruptcy, my mind immediately went to the employees at HBC. The part timers. The full timers. The seasonal employees. The student employees. The “lifers”. The night shift employees. The early birds who stock the shelves. The office workers. The shipping and receiving crew. The janitorial staff. Everyone who makes the stores work.

I know that life well.

Before I became a personal injury lawyer, I worked retail at Sears Canada while I was in undergrad at York University. I worked in the hardware department and in the paint department. I saw the ins and outs of a large department store. I learned all sorts of things about paint, tools, brushes, stains, lawnmowers, power washers, dehumidifiers…. You name the home appliance/tool, I knew about it.

But, more importantly, I learned a lot about people from all walks of life, and how large publicly traded companies work and treat their workers.

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Published on: May 16, 2025

The License Appeals Tribunal is a very strange

By Goldfinger Injury Lawyers

Most people aren’t familiar with how car insurance disputes work until they have to go through the process.

Most would think that if there’s a dispute for benefits, they can sue the insurer which is denying those benefits and then a Judge can decide. That seems simple and straight forward. Unfortunately, simple and straight forward is not the way which car accident cases work in Ontario.

Long ago, accident victims had the right to sue the insurance company which was denying their accident benefits following a car accident. That case could be heard by a Judge, in regular Court. The court date however would only trigger if the parties had attempted and failed a mediation at the Financial Services Commission of Ontario (FSCO). That way, the parties gave it an honest try to see if they could resolve their dispute at mediation, without the need for litigation in Court. This made a lot of sense, and was easy for unsophisticated and inexperienced litigants to understand.

But the rights of accident victims to sue over denied accident benefits following a car accident were stripped from everyone in Ontario. Yes: imagine that. In a democracy, the government took away your right to sue, and access to the Courts.

Instead, innocent accident victims were required to have their disputes heard at the License Appeals Tribunal (LAT). The LAT is not a Court. It’s a tribunal. There are no Judges at the LAT. Instead, there are adjudicators who work there, who may, or may not, have any experience hearing or ruling on car accident cases. The barrier to entry to become an adjudicator at the LAT is much lower than the barrier to entry to become a Judge of the Ontario Superior Court of Justice.

Since the LAT became the ruling body over accident benefit disputes, it’s been an unfriendly place to accident victims (likely by design), and surrounded with controversy. It’s a really strange place.

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Published on: May 8, 2025

Special Economic Zones, Personal Injury Law, and Eliminating Your Rights

By Goldfinger Injury Lawyers

The Ontario Government has proposed legislation to create “special economic zones” in order to speed up large scale projects such as the Ring of Fire, and a proposed tunnel under highway 401 in order to reduce traffic.

The Bill is called Protect Ontario by Unleashing our Economy Act (Bill 5 ) detailed of which can be found here.

As an aside, I love it how governments name their bills. Be forewarned. The name of bills often does the exact opposite of it’s name. It’s a PR play in an attempt at misdirection (kinda like how a magician pulls off a magic trick). It gets the public to look one way; or to think about the legislation in one way; in order to misdirect the public from seeing all of the bad stuff happening which is actually going to happen in a different direction. It’s a way for the government to create a narrative in a way which directs people away from the ugly truth of what’s actually going to take place. The Bill, called “Protect Ontario by Unleashing our Economy Act”, could also be aptly named the “Stripping All of Your Rights so We Can Dig Out Minerals and Build Stuff Really Really Quickly Act“.

If passed, the new law would allow the Ontario government to disregard any provincial laws currently in place (such as provincial environment, labour or insurance act rules) in order to get the project done as quickly as possible, without any red tape. The bill cuts all of the checks and balances in place to protect the public and to protect the environment. It’s being sold to the public as a way to kick start the economy over the threat of Donald Trump and tariffs being imposed by the United States on Canada and Ontario.

It might sound like a good idea, until you pause and think about the ramifications of the proposed bill to plow through all other bills.

For starters, the bill seems completely undemocratic, and borderline totalitarian. The piece of legislation allows the government to do whatever it wants; ignoring legislation what has existed for many years. The rules and laws won’t apply to them once this piece of legislation has passed, and is used. Even if it’s challenged in the Courts as a violation of a Charter Right, the government can enact the Notwithstanding Clause in order to get their way. The Ford Government has used the Notwithstanding Clause before; meaning that they won’t be afraid to use it again. It gives the government total and complete control. That’s what happens when a majority government has been elected. It’s their “mandate“. But, if this piece of legislation were put to a vote, I doubt that the majority on Ontarians would stand behind the idea of giving such power to the government.

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Published on: April 30, 2025

It can be a Long Road for Long Term Disability Cases in Ontario

By Goldfinger Injury Lawyers

It’s not mistake that Long term disability claims use the word “long“. Long is used for good reason.

Long is meant to define the duration of the period from the claimant’s first day off work, to the time period they are eligible to receive long term disability benefits. It’s a “long” period in contrast to a “short” period as found in short term disability claims.

Long also defines the duration for which the claimant is eligible to receive long term disability benefits. That period is longer than you would find in short term disability cases. In most long term disability cases, the eligibility period, or payment period, generally goes up to the age of 65. But, this is fact dependent upon the wording contained in the long term disability policy. In contrast, the duration of short term disability benefits is generally a few months (90 days, 120 days). This too is fact dependent and is specific to the wording of the policy. In any event, the use of the word “long” is meant to distinguish from the use of the word “short” in the case of disability policies.

For personal injury lawyers, and for many disability claimants, the use of the word “long” can also mean something completely different. It can be seen as a reminder to the claimant that it may take a long time to get an answer from the insurance company on whether or not the claim for benefits has been approved or denied.

In other circumstances, it can take a long time for the claimant to get paid their benefits, even after they’ve been approved.

For lawyers, the use of the word “long” is a gentle reminder that long term disability cases take time get through the Courts, or to ultimately resolve by way of Judgment or out of Court Settlement. Make no mistake, there is nothing “short” about a long term disability case once it’s been litigated.

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Published on: April 24, 2025

When International Students and Visitors to Canada have Accidents in Ontario

By Goldfinger Injury Lawyers

When an international student or a visitor to Canada has a serious accident in Ontario, it can get very complicated.

Who will pay for the medical treatment? The hospital visits? The ambulance? The out of pocket expenses? What about the loss of opportunity to pursue their studies, or the wage loss from a part time job?

These are really hard questions, and all depend on the facts of the case, along with the coverage of the injured party.

For starters, people in Canada on Student Visas, or a Visitors Permit won’t have access to the publicly funded OHIP system, the same way that Canadian Resident will. This is why it’s so important for the student or visitor to Canada to make sure that they have proper health care coverage before they come to Canada.

Having bad insurance will end up in a less desirable result. Just because an insurance plan is the cheapest, doesn’t mean that it’s the best. Often, you get what you pay for. Nobody ever expects to be involved in a serious accident, but if one happens, it sure helps to have a responsive and supportive insurer; rather than an insurance company which is the habit of denying claims, or being non-responsive to their insured.

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Published on: April 16, 2025

The Importance of Examinations for Discovery in Personal Injury Cases

By Goldfinger Injury Lawyers

Ontario Courts, along with the civil litigation process are governed by a complex set of rules. These rules are made by people who have an understanding of how the law works, how cases work, and what problems our civil justice system is facing, and how those problems should be addressed.

Every once in a while, the rules are examined and tweaked, in order to better administer civil justice and help the system operate more efficiently.

The Civil Rules Review (CRR) was launched in January 2024, under the leadership of Co-Chairs Justice Cary Boswell of the Superior Court of Justice and a partner at a law firm. The mandate of the CRR is to conduct a comprehensive and complete review of the Rules and identify, through consultation, areas where targeted changes to the Rules would increase efficiency and access to justice for Ontarians, reduce complexity and costs, maximize the effective use of court resources, reduce delay, and leverage technical solutions.

The CRR Group has made a lot of recommendations, which, in my opinion, fail to achieve the goals set out by the CRR. In fact, what these recommendations will bring will be greater injustice to Plaintiffs seeking justice through the civil justice system. The proposed reforms favour Defendants, who need not work hard to advance a claim. It will embolden Defendants to sit back, and really not do much until absolutely necessary to do so.

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Published on: April 10, 2025

Car Accident at Work? Can I opt out of WSIB?

By Goldfinger Injury Lawyers

Let’s say that you get involved in a car accident during the course of your employment. What do you do? Who can you sue? Is it a WSIB claim? Is it a car accident case? Or is it both?

This issue comes up a lot in the practice of a personal injury lawyer, who does a lot of car accident work.

Let’s make something very clear. You cannot both claim WSIB benefits and sue, and claim accident benefits at the same time.

You you only pick one route. That decision, is called an “election“.

The Plaintiff can either “elect” to receive WSIB benefits and go the WSIB route.

Or the Plaintiff can opt out of WSIB, and “elect” to receive accident benefits, and go the suing route.

The Plaintiff cannot go both routes.

Sometimes, a Plaintiff does not have a choice and must go through the WSIB route. Here is an example of such a case:

The Plaintiff is driving his/her company car enroute to a jobsite. The Plaintiff gets involved in a terrible car accident. The car accident is not the Plaintiff’s fault, and the Plaintiff wants to sue the at fault driver for his/her damages and pain and suffering. But, as it turns out, the at fault driver was also driving a company car for a job. Both parties were deemed to be Schedule 1 employees who were in the course of their employment at the time of the car accident. Even though the parties worked for two completely different and unrelated employers, the fact that both were in the course of their employment at the time of the car accident is significant and presents a barrier to personal injury litigation. The reason is that the law says that a Schedule 1 employee in the course of his/her employment cannot sue another Schedule 1 employee who was also in the course of his/her employment (even for a car accident case!). As a result, even though the Plaintiff may want to go the personal injury litigation route, s/he cannot do so. WSIB acts as a shield protecting the employers (and the at fault driver) from any litigation. The injured accident victim has no choice but to pursue WSIB benefits. The injured accident victim can try to advance a claim for damages against the at fault driver; but the case will in all likelihood get kicked out of Court on Application to the WSIB.

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