Insurance

Published on: July 4, 2025

Tips for Dealing with Insurance Companies in Ontario

By Goldfinger Injury Lawyers

It’s not everyday you have to deal with an insurance company. It’s not an interaction which people are accustomed to.

Think about it.

You don’t need legal advice to buy a pair of shoes.

You don’t need legal advice when negotiating a price for a new/used car.

You don’t need legal advice for a parent/teacher conference at school.

You don’t need legal advice opening a bank account, or negotiating the terms of your mortgage.

What’s set out above are adult interactions which we are used to in everyday life.

But, when it comes to personal injury, car insurance and disability claims, we do need legal advice. We need legal advice because these interactions don’t happen everyday for consumers. We need legal advice because there are complicated laws around getting compensation. We need legal advice because more often than not, these claims are disputed and often end up being litigated in Court.

Given that our personal injury lawyers deal with insurance companies on a daily basis, here are some tips which we’ve procured for you based on our experience and expertise in dealing with them.

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Published on: January 9, 2025

So many forms in personal injury cases!

By Goldfinger Injury Lawyers

As the title to this Toronto Injury Lawyer Blog Post will tell you, there are so many forms in personal injury cases. If you wanted the Coles Notes version of this entry, I suppose that you can stop reading here. But, if you’re more interested about the details behind these forms then please keep on reading!

At times, it’s difficult to understand why there are so many forms to complete after you’ve been hurt or injured in an accident. If you don’t want any medical assistance, benefits, or compensation, then you don’t have to complete any forms at all. But, that’s not most people. Most people aren’t seeking compensation for their injuries. They are seeking to be made whole from the financial losses which they’ve sustained; or they are seeking treatment for their injuries which are not covered under the public health care system. This is a common theme. If you’ve missed out on work and income, people want that income back. If you need physiotherapy treatment, you should not be out of pocket having to pay for that treatment. All people want, for the most part, is to be made whole following an injury or accident which puts them out of commission. This isn’t so much to ask….Or is it?

One of the themes in personal injury law, as in life, is that if you don’t ask for something, you will get nothing in return. In personal injury cases, money will not fall from the sky. Nor will your out of pocket treatment, or attendant care, be paid out of thin air because a Defendant, or their insurer is being nice. One must ask for these things to get paid.

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Published on: December 5, 2024

Every Long Term Disability Policy is Different

By Goldfinger Injury Lawyers

The fine print matters. It especially matters in long term disability claims.

The overwhelming majority of personal injury cases are tort cases. They are not predicated on a contract.

Car Accident Cases

Dog Bite Cases

Slip and Fall Cases

Assault Cases

Product Liability Cases

All of these claims are based on negligence in tort law. They are not based on a contract.

Long Term Disability cases are very different because they are entirely based on contracts. That means that the wording of the long term disability policy (the contract) is very important to whether or not the case succeeds, or fails. One word in the contract can change the entire case.

A Plaintiff can be very seriously injured. But, if the wording of the long term disability contract is not in their favour, they might not win the case.

It’s important for a Plaintiff to know that the wording of every long term disability policy is different. This is significant because just because somebody you know won their long term disability case does not mean that you will win your case as well. There are so many different variables which go in to winning (or losing) a long term disability case. The wording of the long term disability policy is a great place to start.

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Published on: November 20, 2024

Not Being Able to Sue for Personal Injuries in a Car Accident Case

By Goldfinger Injury Lawyers

This week, the Provincial Government of Alberta will announce that people will no longer be able to sue for personal injuries arising from a car accident. I hate seeing when governments take away the rights of innocent people to best suit their corporate overlords.

This dramatic change to the law means innocent accident victims won’t be able to sue for personal injuries against:

Drunk Drivers
Distracted Drivers
Drugged Up Drivers
Incapacitated Drivers
Careless Drivers
Drivers too high to operate a vehicle
Driving driving illegally without a license
Grossly negligent drivers
Drag Racers
Stunt Drivers
Criminals who have stolen a car and who operate their vehicle like it’s Grand Theft Auto causing a serious collision and life threatening injuries. See the serious collision which took place on November 18, 2024 at Bathurst and Wilson in North York where a driver on bail operating a stolen vehicle hit a TTC Bus, injuring 9 innocent individuals.
Defendants who drive their vehicles so poorly, and so negligently, that they cause death to innocent people who are simply in the wrong place, at the wrong time
Anyone else who acts a fool behind then wheel and causes injuries to another innocent person

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Published on: February 28, 2024

Who says that personal injury laws are supposed to be fair?

By Goldfinger Injury Lawyers

I’ve had a few interesting conversations over the past few days with some very thoughtful, rational, insightful and logical people. These people are not lawyers. They have no skin in the game when it comes to the field of personal injury law. That means that they are neither lawyers, insurance adjusters, service providers, doctors, or lobbyists. It’s always nice to get someone’s perspective on the law, and how they perceive it works (or doesn’t) from an “outsider“.

For whatever reason, they were thinking about how the law worked in Ontario. And, in particular, how auto insurance claims worked. They were thinking along these lines because recently, a friend or family member had either been involved in a serious car accident, or something bad happened to their car which required that they get the auto insurer involved.

All of their experiences shared some common threads.

For starters, the people didn’t understand why the insurance claims system was so complicated. Why did the system need to be so complex, with so many hard to understand forms? It was like you had to have a law degree or some expertise in personal injury just to get the insurer to approve a benefit. And just because a benefit was deemed approved, does not necessarily mean that the money would be flowing in a timely manner.

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Published on: December 13, 2023

Qualifying for Long Term Disability vs. Qualifying for Canada Pension Plan Disability

By Goldfinger Injury Lawyers

Long Term Disability Law can be rather complicated.

It’s complicated because Long Term Disability is based in contract, and every contract is different.

For many people, understanding the words and concepts contained in these long term disability contracts is hard to grasp, and confusing. I can’t say that I blame them.

Take a dog bite case for example. If a dog attacks you, and causes injury to you, then the owner of the dog ought to be held responsible for your injuries and losses.

Long Term Disability cases don’t work that way. Simply because you are disabled, or unable to return to work, does not necessarily mean that you are entitled to long term disability benefits.

And, even if you are eligible for long term disability benefits, the quantum of that benefit, along with the payment duration will be in question as well.

There are a lot of fluctuating variables when assessing and quantifying a long term disability case. We call these moving targets. Those targets don’t move as often, or as frequently, with a straight tort claim, like a dog bite case, as they do with a long term disability claim.

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Published on: November 14, 2023

Adverse Cost Insurance for Personal Injury Cases in Ontario

By Goldfinger Injury Lawyers

Over the past decade, personal injury lawyers have seen an explosion of a new insurance product offered to their law firms and to their personal injury clients. It’s called Adverse Cost Insurance or After-The Event Insurance.

How does it work and what does it do?

Adverse Cost Insurance or After-The Event Insurance serves to protect a Plaintiff from an adverse cost award following an unsuccessful trial. At trial, if a party loses, the Judge will generally order that the losing party pay the winning party’s legal fees. Those legal fees, especially after a trial can be very high. This insurance product is there to cover all, or part, of those legal fees which the losing party is ordered to pay by the Judge.

What are the benefits to this insurance?

In theory, the insurance will pay for part, or all of the legal costs if you’re unable to do so on your own.

Let’s imagine a scenario whereby a Plaintiff in a car accident case loses his/her case. After the lengthy trial, the Judge dismisses the Plaintiff’s case, and orders that the Plaintiff pay the Defendant’s legal costs in the amount of $500,000. This is entirely possible. In fact, it recently happened in the case of Belton v. Spencer. In that case, Belton sued Spencer for damages as against Spencer as a result of an accident that he sustained while walking Spencer’s horse .

Following a trial lasting over eight weeks, Belton’s action was dismissed as against Spencer. The Judge ordered that the Plaintiff Belton to pay $350,000 in legal fees plus HST, and $74,472.52 in disbursements, for a total of $469,972.52 to the Defendant Spencer. Ouch!

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Published on: November 2, 2023

Unavoidable and Inevitable Accidents In Ontario

By Goldfinger Injury Lawyers

When a car accident happens, you would like to think that the insurance company insuring the at fault driver will pay out on a meritorious claim.

That makes sense.

But more often that not, insurance companies try to avoid (putting it kindly) their obligation to pay out on such claims. They will leave no stone unturned in an attempt to get out of paying. Smart tactic when it works. But breaches all conventional norms of decency when it fails. But a little egg on the face of an insurer isn’t a new thing.

One of the ways that they can avoid paying out on claims is by attempting to nullify the insurance for the Defendant at fault driver.

They can do so in a number of ways.

One of the ways is to declare that the at fault Defendant driver didn’t have any sort of insurance coverage in the first place.

This happens more often that you would think. During the Pandemic, many Ontario drivers stayed at home on account of COVID and the lockdowns. These motorists had cars, which weren’t being used at all. They were just sitting in the garage, all the while the motorist was paying insurance premiums. Many of these motorists temporarily cancelled their car insurance during the Pandemic to save a few dollars. This makes perfect sense.

But the problem became that many of these drivers who removed coverage, forgot to reactivate their coverage when the world opened up again. The result was that they thought that they were driving around with proper insurance coverage, but in reality; they were not.

In that example, the insurance coverage is well within their rights to deny coverage for a car accident which took place when there was a temporary hold, or removal, of the insurance coverage. You don’t get coverage for free.

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Published on: May 11, 2023

Suing your Mom or Dad or another family member in a car accident case

By Goldfinger Injury Lawyers

When I was a young personal injury lawyer, an odd case appeared on my desk.

The Plaintiff was an older automobile executive, who broke 3 vertebrae, torn his rotator cuff and fractured his skull in a car accident.

The injuries were quite significant. They prevented the client from returning to work, or engaging in his usual personal care and recreational activities. His life would be forever changed as a result of the car accident.

What was odd was that the car accident was a single car accident. The client was a passenger in the vehicle. The driver had lost control, drove the car off the shoulder of the road, and flipped the vehicle into a ditch along a deserted country road. I imagine that the car accident could have been even more serious had there been more vehicles involved.

So, in that case, the passenger would sue the driver for having lost control and flipped over the vehicle.

In this case, the driver was the client’s own daughter.

Isn’t that strange. A father, needing to sue his own daughter for his personal injuries arising from a car accident. It’s not like the daughter intentionally tried to flip over the vehicle. It was, by all accounts; an accident.

But how does that work, and what are the ramifications of a father, having to sue his own child for damages in a personal injury case? Can the daughter go to jail? Will her credit rating be ruined forever? Does she need to hire a personal injury lawyer to defend her claim? Will she need to go to trial and square off against her own father in open Court? Will this father/daughter personal injury case get really nasty such that Dad will take away Daughter’s TV and cell phone privileges?

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Published on: April 21, 2023

Damages in Personal Injury Cases (Ontario)

By Goldfinger Injury Lawyers

The entire field of personal injury law is rather effective at making sure that accident victims aren’t unjustly enriched by the benefits or moneys which they receive in their case.

Cases have been fought all the way to the Supreme Court of Canada to make sure that innocent accident victims aren’t getting their cake, and eating it too.

Insurance companies will fight tooth and nail to make sure that Plaintiffs don’t double dip.

It can be hard for innocent accident victims to understand that laws against double dipping exist. Many think that legal remedies are an all you can eat buffet. Unfortunately for Plaintiffs, they are not.

The laws surrounding remedies, damages and set offs exist because at law, an accident victim is not allowed to be put in a better position post accident, than they were pre-accident. The laws surrounding compensation exist to make a person whole again; and not to put them in a better position than they were pre-accident.

The accident should not be seen as a monetary windfall for the Plaintiff. It should be seen as a means to an end to make them whole for their past losses, and those losses moving forward.

Certainly, an insurer will have a more conservative valuation of what those losses are. While a Plaintiff will have a more aggressive valuation. Where that number lies is often somewhere in the middle. But, it’s important to state that a Plaintiff can only be awarded what’s recoverable at law.

Many clients want to see the Defendant suffer. They want to see the Defendant go to jail, or become their butler until the end of time as compensation for their damages. Plaintiffs want to own the Defendant’s home, all of their prized possessions, and receive a public apology in four national newspapers. The law just doesn’t work this way. A Judge cannot sent a Defendant to jail in a civil personal injury case. The only thing that the Judge can do is order the Defendant pay the Plaintiff compensation within the framework of the law.

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