Our law firms handles a lot of car accident cases from across Ontario. Each case is different. But, many car accident cases all carry common threads, and common themes.
At the most basic level, a car accident case will involve Defendant Driver causing a car crash involving a Plaintiff Driver. Defendant driver will have made some sort of mistake or misjudgment while driving which personal injury lawyers refer to as negligence. If the Plaintiff cannot establish negligence (or fault) on the part of the Defendant driver, then, the case will likely fail. In order to succeed in a personal injury case, the Plaintiff must establish some sort of tort against a Defendant. This is called a cause of action. If there is no cause of action (like negligence), then a Plaintiff cannot win his or her case.
Some injuries are really bad, or catastrophic as a direct result of a car accident. Some of the worst injuries which our personal injuries lawyers see are spinal cord injuries (or injuries to the back or lumbar spine). These injuries can leave an innocent accident victim paralyzed and requiring around the clock attendant care along with loads and loads of car costs which unfortunately might not be covered by OHIP.
This is an important point which all accident victims and their loved ones need to consider. It’s a common misconception that Canada’s publicly funded health care system will pay for all care costs. This simply isn’t true. There are a lot of services and treatments which are reasonable and necessary for a seriously injured accident victim which are NOT funded by healthcare in Canada. These treatments and services are often necessary for helping an injured accident victim to regain their health. Some of these treatments and services include, but are not limited to:
- Physiotherapy
- Massage
- Speech Language Pathology
- Occupational Therapy
- Personal Support Worker
- Chiropractic Care Services
- Nutritionist
- Psychology/Counselling Services
- Social Worker
- Neuropsychological Assessments
- Rehab Coach
- Case Management
All of these services are great. In theory, you would want them to be available to any innocent accident victim. But, the reality is that all of these services come for a price. They aren’t free in the community through Canada’s publicly funded health care system.
And this is why insurance matters. Having collateral benefits which will cover the entire cost; or part of the cost of these rehabilitation services is great. Or, having a cooperative car insurer which will fund the cost (or part of the cost) of these services is very helpful as well. But, you have to keep in mind that car insurers don’t profit from having to constantly pay out of these services. The more money which they pay out in services, the less money which they get to retain in profits. Insurers don’t make money on paying out on every claim, and every claim demand which comes through their door.
This is the frustrating part of many accident victims. Particularly in car accident cases where people find out that they have access to accident benefits following a serious car accident (like when there is a spinal cord injury). You would think that treatment benefits would rain down from the skies and be plentiful. Quite the contrary. In many cases, having accident benefits flow for treatment you would think would make logical sense to fund, gets denied. This is where personal injury lawyers come in handy. But, the problem is that while your personal injury fights at a Tribunal for your benefits; your are NOT receiving benefits during that period of time. In many instances, it can take well over a year to secure a hearing date. Just because a hearing has taken place does note mean that the decision will be released right away. It takes times for decisions to be released as well. Furthermore, just because a decision is made, does not necessarily mean that the decision is final. Both parties have the right to appeal a decision made at the License Appeals Tribunal. So, if an insurer losses a case and is ordered by an adjudicator to pay for treatment, and then the insurer appeals that decision; the claimant must wait for the appeal to be heard and then decided by a Judge. The same delay in securing an appeal date applies to securing a hearing date at a tribunal. None of these administrative wait times are good for an innocent accident victim who is looking to get treatment following a serious car accident.
Some clients want to know if they can self fund the cost of treatment which gets denied by an insurer. This means that they will personally pay for the cost of the treatment out of their own pocket, and then hope to get reimbursed for those costs at the conclusion of a hearing or a trial. There is nothing preventing an injured accident victim from paying for his/her own treatment. If the Plaintiff can afford the cost of the services, and they deem those services to be helpful, then why not. But, keep in mind that there are no guarantees in litigation. This means that there is no guarantee that the Judge or Adjudicator will Order that these out of pocket expenses be reimbursed. Some people see this as a license to spend, because they have an ongoing lawsuit; therefore they will be assured that they will be compensated for their out of pocket expenses relating to treatment. This could not be further from the truth.
Off the topic now of personal injury law, and more on the Kawhi Leonard reporting in Toronto. It appears that Kawhi Leonard asked for part ownership of the Toronto Maple Leafs in his free agent demands to the Toronto Raptors. This is quite the ask. If a player knew, or ought to have known that his demands infringed on the collective bargaining agreement, should he be penalized for that? If a team ever made such an offer, that team would certainly be penalized. So, why doesn’t the sword cut both ways? Keep the players honest in their negotations. Keep the teams honest as well.