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Articles Posted in Insurance Coverage

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On June 22, 1990, the Ontario Government introduced the threshold for general damages in car accident cases. This meant that each injury needed to be deemed as a “serious and permanent impairment” of an important physical or psychological function. If the personal injury did not meet the medico legal threshold in the eyes of a Judge, then the case on damages for pain and suffering would fail,; regardless of fault. This seemed rather harsh to an innocent accident victim, but it was the new state of car accident law in the Province of Ontario.

The reason the threshold was introduced by the Ontario Government was to reduce the amount of personal injury claims. The fewer claims, the less money that insurers would need to pay out. This would save insurance companies huge sums of dollars. Those savings were intended to be passed along to every day drivers; like you and me. This is important because having car insurance in Ontario is mandatory when you drive a car. That makes car insurance a hot button election issue. Drivers want cheap insurance. Cheaper insurance was the promise from insurers and the government when the threshold was introduced. This was the trade off and the handshake deal between insurers and the government.

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Personal injury cases are never as simple as they might appear to be.

The case of an apparently simple slip and fall, just isn’t so simple.

On the surface, the case is very easy to summarize. A person is walking on a private walkway. The walkway was not properly maintained for the winter. The person slips, falls, and breaks their ankle. Ouch!

On the surface, the Plaintiff would sue the private property owner. That makes total sense. The dynamic of the litigation would be a single Plaintiff against a single insurer acting on behalf of the private property owner.

But that’s not what actually happens.

The private property owner is not a single entity. The property is owned by three different corporate entities (that’s three different defendants). All of these Defendants may have different insurers for the loss, or they may have the same insurer under one policy. Your personal injury lawyer can find this out once the litigation proceeds.

The property owners inform your personal injury lawyer that there was a property management company. That’s an additional Defendant to add to the mix, with a different insurer altogether.

Now that the property management company is added, they inform you that there was a winter maintenance contract in place. That’s a 5th Defendant to the mix.

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The title to this Toronto Injury Lawyer Blog post may strike you as a bit odd; but it’s one of the top questions I’ve been receiving since the horrific terrorist attacks of October 7, 2023.

What makes Canada a great country is that we have all sorts of freedoms. But, these wonderful freedoms are not absolute.

In a multicultural society, and in a more homogeneous society, not everyone is going to agree on the same issues, statements or views. It’s a fact of life.

When people don’t agree, or hear things that they don’t like, they can get mad or upset. This may cause them to yell, or even to say grossly offensive, or racist statements. Things might get so heated that it results in damage to property, or physical violence.

So, when someone is shouting racist, homophobic, vile or antisemitic comments at you or at at group, does this make grounds for a viable civil lawsuit against that person, or group of people?

Great question!

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It’s a legal requirement to drive a motor vehicle with car insurance.

Section 2(1) of the Compulsory Automobile Insurance Act states:

Compulsory automobile insurance

(1) Subject to the regulations, no owner or lessee of a motor vehicle shall,

(a) operate the motor vehicle; or

(b) cause or permit the motor vehicle to be operated,

on a highway unless the motor vehicle is insured under a contract of automobile insurance

In plain language English, this means that if you are driving a motor vehicle without insurance, you are breaking the law.

The consequences for breaching the Compulsory Automobile Insurance Act can be significant. It’s not a criminal offense, but the fines and consequences for driving without car insurance can add up quickly.

Section 2(3) of the Compulsory Automobile Insurance Act sets out the penalties for driving without insurance. Those penalties are set out below. If you don’t want to read the “leagalese”, I’ll quickly summarize those penalties for you. A Justice of the Peace can fine you (not more than $50,000 after multiple offenses), can take away your driver’s license, can impound your car, and can charge you for the costs of impounding your car.

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When you think of a car accident case, the basic premise is that there was an accident; an at fault party; and the at fault party is responsible to pay for the injured party’s damages and losses.

Some cases certainly work that way. But the vast majority of cases do not.

There are a lot of moving parts behind the scenes which non-lawyers rarely see; but which lawyers see all too often.

These moving parts have to deal with insurance coverage. Insurance coverage will result in the defendant’s ability to pay for a Plaintiff’s damages and losses.

You see, it’s not enough for a Defendant to be found responsible for pay for the damages and losses in a personal injury lawsuit.

Just because a Defendant is deemed responsible, does not translate into a Defendant’s ability to pay for those losses. This is a very important distinction.

Take the example of a Defendant who has no assets to his/her name, and who is in tremendous debt. How would that individual Defendant have the ability to pay out of a Judgment awarded against him/her? It wouldn’t be possible unless that Defendant was put on some sort of payment plan which s/he would never be able to fulfill. In Canada, simply because you don’t pay a debt does not mean that you go to jail. Nor does it mean that you have to give up all of your worldly belongings.

And it’s for these very reasons that the topic of insurance coverage is so important in a personal injury case. Coverage will determine whether or not there are real assets there for a Plaintiff to recover upon. It will also determine who is responsible to pay for what. Continue reading →

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Sounds like a typical law school fact pattern for a tort case.

A property owner retains an arborist to do a routine pruning job on a set of Norwich Maple Trees in his yard.

The arborist advertises that he is both “licensed” and insured.

Upon attending at the job site, the arborist begins to unload his equipment from his van. It includes all of the normal stuff which any arborist would carry: spikes for climbing trees, ropes, counter weights, pylons and chain saws etc. But is also includes something which you shouldn’t find on any job site; an open container of alcohol; in this case a tall boy of beer.

Having an open can of beer may not seem like a big deal. The general labourers there to help the arborist tell the property owner that having a beer on the job site isn’t a problem; and that they do it all the time. They tell the property owner that this is just the way that the licensed arborist works. He needs beer to concentrate and do his job. They are trying to pass this off like it’s all normal.

The notion that a man climbing 20+ feet in the air; with a large gas powered chainsaw; needs to be fueled by alcohol isn’t normal whatsoever.

Yet, this is what the arborist and his friends tried to convey to the property owner.

In case you are wondering, that property owner was me. And I’m a personal injury lawyer. And I wasn’t having anything of it.

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Ontario is scheduled to drop most mask mandates by March 21, 2022. Whether or not this is the right move or not has nothing to do with being a personal injury lawyer; so I’ll just stay in my lane.

But, in creeping closer to this date we have seen an uptick of assault calls surfacing at our law firm. These assault claims are no uncommon, only we have seen more and more of them as the pandemic has dragged on.

It has become apparent to me that over the course of the pandemic we have forgotten how to interact with one another and share public spaces. It seems that more of us have a sense of entitlement, together with a disregard or a lack of respect for the safety and security in public places. In other words, we forgot how to share space and how to interact in public groups. This is something that will take time to re-learn. But, we will get there.

In the meantime, what do you do when a stranger assaults you? Do you have a personal injury case? And if so, how do you pursue that claim?

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Sometimes things which are presented to you sound too good to be true. This can ring true in the sale of insurance products; such as critical illness insurance. When things sound too good to be true, they should be looked at with skepticism.

Our law firm handles critical illness claims. Anyone can purchase a critical illness policy and receive coverage (provided that they are approved for said coverage). More often than not these policies are sold by independent insurance brokers/agents.

As with any industry, there are some excellent brokers/agents. And there are some less than excellent agents/brokers.

Ultimately selling insurance is largely a commission based business. The more policies which an insurance broker sells, the more money s/he will earn. That means there is a direct financial incentive for a broker to sell you a policy of insurance; whatever that policy might be.

Many people want to protect themselves in the event of injury, disability or illness. One of the ways of doing so is by purchasing a critical illness policy. Of all of the living policies, the critical illness policy is the equivalent to hitting the jackpot on the slots in Vegas. It’s a lump sum payout for a critical illness as defined by the policy. This is attractive for many consumers when comparing it to a disability policy which pays a monthly disability benefit which is subject to an all source offset and whereby the definition of disability changes at the two year mark. One lump sum from the insurance company sounds much better to most people. There is no need to worry about an on going multi year relationship with the insurance company. If all goes well the insured can receive his/her lump sum payout and move on with their lives. As oppose to a long term disability claim where the insured will be in a month to month relationship with the insurance company until the end of the claim (which can take many years to wrap up).

Critical illness policies are high risk, high reward policies which insurance companies don’t so easily pay out on. They will require substantial medical evidence in order to approve your claim. It’s not as easy to get approved as you will think.

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In tort law, one of the first and most important things lawyers are taught is to sue a Defendant with deep pockets and an ability to pay out a Judgment.

The only remedy in a personal injury case is money.

There is no ticker tape parade for the victor of a lawsuit. The Court cannot order the Defendant apologize, or be your servant for as long as it takes a Plaintiff to recover from his/her injuries. All which a Judge or Jury can do is order that the Defendant pay you compensation for your injuries and damages.

If a Defendant does not have the ability to pay the Judgment, it doesn’t mean that they go to jail. It also doesn’t mean that they can’t drive a car, work, or otherwise have their freedoms taken away. If a Defendant doesn’t pay, and doesn’t have the assets to pay a Judgment; then the Plaintiff is out of luck. The Judgment is without any real monetary value. While it may be satisfying or vindicating for a Plaintiff to have “won” the case; if the Defendant doesn’t have the ability to pay the Judgment the Plaintiff won’t get any compensation.

This is why it’s so important for a Plaintiff to sue a Defendant who has the ability to payout on a potential Judgment. This is why insurance matters.

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The Workplace Safety Insurance Board (WSIB) provides no fault insurance coverage for injured workers in workplace accidents.

When workers have been injured in the course of their employment; often they look to our law firm to sue their employer.

But here’s the catch. And oh boy; is it ever a big catch.

You see, the thing is, in the vast majority of cases, you cannot sue your employer for your workplace injuries. There are certain exceptions like working for a bank, a law firm, or a funeral home. But in the vast majority of cases, you cannot sue your employer for their negligence giving rise to a workplace injury.

Employers are given one of two classifications. They are either classified as Schedule 1, or Schedule 2 employers. The marjority of employers fall under Schedule 1.

A Schedule 1 cannot sue his or her own Schedule 1 employer. They will be forced to make a WSIB claim. In the event that they find a personal injury lawyer to take on their case and sue their employer for their workplace injuries, the Defendant will bring an Application to the Worplace Safety and Insurance Appeals Tribunal (WSIAT) to have the lawsuit kicked out of Court and force the injured worker to pursue a WSIB claim.

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