Articles Posted in Accident Benefits

If insurers paid out maximum compensation on each and every claim, there wouldn’t be any need for personal injury lawyers or paralegals who focus on benefit accident claims.

Why does an injured accident victim or disability claimant need a lawyer, if the insurer is paying them out the full value of their claim up front; without any hassle?

But, if an insurer paid out the maximum value of each and every claim which came across their table, chances are they wouldn’t be as profitable as they are; or profitable at all.

As much as we are made to believe that insurers are there to look out for our best interests and pay out when they are supposed to; at the end of the day; insurance companies exist to MAKE MONEY.

Many Canadian insurance companies trade on the Toronto Stock Exchange (TSX). Here are a few examples along with their stock symbols, along with current share values as of the time of preparing this Toronto Injury Lawyer Blog Post on July 7, 2015:

Intact Financial Corp: IFC $90.57

Sun Life Financial: SLF $41.80

Manulife Financial: MLF $23.03

Co-Operators General Insurance: CCS-PS $23.79

Those are just a few of the examples of insurance companies which do business in Canada, who trade of the Toronto Stock Exchange.

Those stock symbols and share prices are VERY important. If those share prices drop significantly, millions, if not billions of dollars will be lost value and options for shareholders around the world.

If one of these insurers paid out ALL claims, regardless of merit of an entire year, chances are those stock values would dip dramatically.

So, when accident victims or disability claimants wonder why so many claims are denied at first instance, or why insurers refused to believe what their doctors have to say about their injuries, there is a financial reason for this.

The more money an insurer pays out to your for your claim, the less money they get to report in profits for their share holders.There are certainly a variety of their factors involved in insurer profits, but this is one of the most tangible concepts for accident victims and disability claimants to understand.

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Our law firm does NOT handle any WSIB matters. Imagine that…a personal injury law firm refusing work!

But that’s right; our law firm doesn’t touch WSIB work. There are a lot of reasons we don’t practice in this area. Aside from the WSIB being an archaic, overly complicated system; the reality is that it does not adequately compensate injured workers. The awards are rather pitiful, hard for workers to get, and their system of unbiased assessments is “impartial assessors” is a farce. There are a number of economic reasons why our law firm doesn’t do WSIB work, but that’s pretty much all you need to know about WSIB.

You will be hard pressed to find a reputable lawyer in Ontario who does exclusively WSIB work, but there are a handful of them around if you’re lucky enough to find one and have them take on your case at a reasonable rate.

There are times when WSIB and civil tort law intertwine. When this happens, we are there to help people make the right decisions so that their cases get off on the right foot.

For starters, you CANNOT receive bot WSIB benefits and SUE. You can’t have both. You either get one, or the other. This is very important for any accident victim to know.

There are instances where injured workers CANNOT sue. If they’ve been hurt or injured on the job site, there are instances where the injured party MUST pursue a WSIB claim. In such instances, it’s important to find out if your employer is a Schedule 1 or Schedule 2 employer. The difference is that is that you CANNOT sue a Schedule 1 employer; while you can sue a Schedule 2 employer. How do you find out if you’re dealing with a Schedule 1 or a Schedule 2 employer? That’s easy. All it takes is a call to the WSIB at 1-800-387-0750. Just ask the person who picks up the phone. It’s an easy search for their staff to make.

Banks, Veterinarians, Law Firms and some other employers are NOT require to have any form of WSIB coverage. So, it’s open season to sue these employers for their wrong doing.

At the end of the day, it’s important to keep in mind that WSIB acts as a shield for employers. They pay in to an insurance plan known as WSIB, and it’s there to protect them in the event of a worker getting injured.

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Intact Insurance has some great television commercials where an terrible accident happens (like a car driving in to a swimming pool); followed by a scene involving an insurance policy holder calling the insurer over the phone. The next scene is that of a well lit and pleasant call centre whereby an insurance agent from Intact proceeds to collect that person’s information and open up a claim in 5 minutes or less. Pretty impressive! The ad is meant to show the ease and speed in which Intact can open a file and process your claim.

Because that’s exactly what all Ontarians are looking for when choosing an insurance company. We’re not looking for low rates, or good customer service. We’re looking for speedy claims opening procedures. They’re fast, so we know they’re good.

The commercials are pleasant and well executed. They are.

A casual observation from this injury lawyer: the television commercials don’t show any personal injuries, and physical injuries. The only damage is comical or cartoonish.

One ad has the car driving in to the swimming pool, another ad has a car driving in to a mail box. Nobody is hurt. It all looks like an honest mistake where everyone is calm, able to smile, and having a relatively good time. Of course, all of this is intentional to keep the air of the ads light; rather than be downers and show catastrophically injured accident victims and crying family members waiting attentively by a hospital bedside attending to their seriously injured loved ones.

Here is the reality of most claims:

1) If it’s a car crash, there are likely injures. In many cases, there are serious injuries. Sometimes the injuries are so serious that the accident victim can’t talk.

2) The claimant isn’t all bubbly and happy when making the call, no matter how pleasant the agent is on the other line. The claimant is upset, mad, stressed, nervous, anxious, or pi$$ed off for lack of a better term that they were involved in a serious accident and now have to make a claim.

3) The claimant might not speak the best English; making reporting the claim difficult. Language can always be a barrier to getting these things sorted out.

4) The person on the other line might not be as bubbly, welcoming and friendly as they appear in the commercials

Here’s something which you probably didn’t pay attention to in these commercials. The person who was working in the call centre for the insurer was sitting at a desk, in front of a computer and inputting information in to their system. They may be taking notes of the conversation, OR the conversation may be recorded for “customer service purposes“. The claimant who initiated the telephone conversation isn’t taking any notes, nor are they depicted as sitting at a computer an inputting information in to a computer system.

Don’t overlook this tiny detail. It’s important. Want to know why? Read on and find out.

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The governing Liberals announced Ontario’s budget on April 23, 2015. Finance Minister Charles Sousa, backed by Premier Kathleen Wynne were in fine form that day. When one thinks of the term “budget“, we would think of all things financial, including taxes, public spending on healthcare, infrastructure, and education. And to be fair, healthcare, infrastructure and education were all addressed in the 2015 budget.

But what often gets swept under the rug without any debate, deliberation or consultation with stake holders is CAR INSURANCE.

Why is this such an important topic? Well, for starters, if you want to drive a car in Ontario, you need to have car insurance. It’s the law. Check the Compulsory Automobile Insurance Act. That’s right. Ontario has a specific act regarding operating a motor vehicle WITH car insurance.

So, if Ontarians are required to operate a motor vehicle with car insurance, then it’s going to be important to all motorists in the province. This amounts to a lot of people. And if all of these people need to have car insurance, then the product they’re required to purchase better be a good product, and protect their rights in the event of property or physical damage.

For insurance companies, car insurance is important because it’s a way for them to make money. What the legislation says regarding what insurers are required, and not provided to require under these policies of insurance goes straight to their bottom lines. The more they can charge by providing the least amount of benefits will increase their profits and make their shareholders happy.

For politicians car insurance is important because if rates are too high, then voters are unhappy. So, the aim of politicians when tinkering with car insurance is to get the cost of car insurance down. But how do they do that? The government doesn’t set car insurance rates. But they do however legislate what benefits are required to be provided in said policies and how benefits work; which ought to have some form of correlation with the price of car insurance (among other factors such as driving record, age, where you reside, driving experience, and the type of vehicle your drive).

So how has car insurance in Ontario been affected since the new budget was announced? Keep reading and I will share that with you.

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The laws continue to get tougher and tougher on accident victims in Ontario for no apparent reason.

Why?

It’s not like the victim of a drunk driving accident did anything wrong. So why is it then that innocent accident victims are being treated like criminals at every turn when dealing with large insurance companies? Is this the new reality?

It seems this way because it really is this way.

When No Fault Accident Benefits were introduced in Ontario circa the 1980’s, it was introduced as “consumer protection legislation” intended at helping accident victims recover from their injuires. In plain English, the laws were created and intended to PROTECT and ASSIST the CONSUMER (that’s you), in your time of need.

There was a contract in place between insured and insurer. The driver would pay premiums to the insurer. In return, should the driver need the insurer’s assistance, the insurer would step in and provide benefits to their insured so they could get back on their feet to business as usual.

So where did things go wrong?
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