Articles Posted in Insurance

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The term “long term disability benefits” would lead one to believe that those benefits should last for a long time.

But the term “long” can be misleading and subject to interpretation. Like many things in the practice of the law, the devil’s in the details and you gotta read the fine print.

So while your friends and family may tell you that your “long” term disability benefits will last for a “long” period of time (like your entire life); don’t be mislead.

Different policies of insurance carry different definitions for the duration of those long term disability benefits.

Here are a few examples:

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Ride hailing companies like Uber and Lyft have dramatically changed the way we get around. Hailing a car from a ride share service is convenient, fast and easy.

The increased popularity of these services has created many hiccups for personal injury lawyers, and insurance companies alike.

To give you an idea of the popularity of drive sharing services, in March 2019 in Toronto, nearly 176,000 trips were taken. That’s a lot of trips!

The first major pitfall we saw as personal injury lawyers is what policy of insurance was appropriate for ride share drivers?

A standard car insurance policy wouldn’t cut it because these vehicles were being used for commercial purposes. There are different driving patterns and risks associated with insuring commercial vehicles versus insuring normal residential communing vehicles. Add to that the additional risk of drivers taking on strangers in their cars, driving to/from unfamiliar places with timing constraints to get to a certain destination on time; it all adds to additional risk for insurers.

The first drive share cases which personal injury lawyers saw dealt with accidents involving such vehicles, where insurance companies were denying coverage because the driver failed to disclose that they were driving the vehicle for commercial purposes.

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Lots of people call my law firm for legal advice for their long term disability claims. Often for these people, it’s their first time dealing with a large insurance company over a claim of significant value which can impact the course of their financial security for the rest of their lives.

Questions like:

What should I (or shouldn’t) say to the adjuster over the phone?

How do I complete all of these forms?

Who should complete these forms?

When should I apply for long term disability benefits?

How can I apply for long term disability benefits?

What must I do once my long term disability claim gets denied?

Should I appeal the long term disability insurer’s decision; and if so; how do I go about that?

When should I retain a long term disability lawyer?

How much will retaining a long term disability lawyer cost?

How long will my case take to get settled or go to trial?

As you can see, people have a lot of questions regarding their long term disability claims. This is completely understandable. Long Term Disability claims are hard to understand right off the bat! They are contractual disputes. The terms of each contract are different. They all depend on the wording of the policy and each policy of insurance is similar; but it’s NOT the same. This is what makes things a bit confusing.

A car accident is easy to understand. In a car accident case, an at fault driver causes a car accident and is held accountable for the pain, suffering and ensuing economic losses they have created through their own negligence.

A long term disability case is based on the wording contained in the policy of long term disability insurance. These policies are long, verbose and hard to understand. There are multiple clauses, exceptions, time periods etc which makes hard even for an experienced long term disability lawyer to understand.

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Long Term Disability insurance isn’t easy to understand. It’s not a common tort or a common cause of action.

It’s not an intentional act which causes harm, or a negligent act by an individual defendant which causes harm. That means it’s not easy for many people to understand.

Here’s a concept that’s easy for people to understand:

A Red Honda Civic runs a red light and t-bones a Blue Cadillac. The driver of the Red Honda Civic which ran the red light is charged and convicted for his bad driving. The passengers in the Blue Cadillac are all seriously injured in the car accident. The innocent accident victims in the Blue Cadillac sue the at fault driver of the Red Honda Civic.

In this very brief fact pattern, we have liability (the driver of the Red Honda Civic is at fault), and we also have damages and causation (the passengers of the Blue Cadillac got injured; and those injuries were a direct result of the negligence of the Red Honda Civic driver). The personal injury case against the at fault driver of the Red Honda Civic is clear and easy to understand.  This case is built in tort and based on negligence.

These concepts are relatively easy (in comparison to other causes of action) to understand.

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It’s not often that the Toronto Injury Lawyer Blog comments on cases decided at the Human Rights Tribunal of Ontario.

The reason being is that car accident cases, slip and falls, long term disability cases, motorcycle accidents etc. are all dealt with before the Ontario Superior Court; not the Human Rights Tribunal.

But ever so often, cases heard at the Human Rights Tribunal of Ontario intercede with cases relevant to the field of personal injury law in Ontario.

Talos v. Grand Erie District School Board is one of those cases.We here at Goldfinger Injury Lawyers believe this to be a very important decision for employees, employers, insurance companies and lawyers alike.

In 2006, the Province of Ontario passed a law that ENDED an employer’s right to terminate an employee at the age of 65. This allowed people to work much longer, and ended discriminatory practices based on age to people over 65.

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One of the most common questions which personal injury lawyers must answers is “how much is my case really worth“?

This question is never easy to answer. These questions are largely fact specific. Even the most serious analysis of the facts and evidence cannot predict the answer with pin point accuracy. The reason for this is that the majority of personal injury cases are heard by juries. Juries by their very nature are unpredictable. Judges can be unpredictable as well. If the Judge and Jury like the Plaintiff, then the award will likely be larger. If the Judge and Jury don’t like the Plaintiff, then the award will likely be smaller. In any event, predicting the outcome of a personal injury case, along with predicting the value is not an exact science.

There are certainly guidelines and parameters which personal injury lawyers use to predict the range of damages for a case. Precedent case law is certainly the most accurate tool for that. The general public can look up old cases FOR FREE on a great website called Canlii.

Free to use. Easy to navigate. With relatively good case updates, although not a comprehensive list of cases; Canlii is certainly an excellent resource even for the non-lawyer.

Some easier predictors for case valuation are long term disability cases. The reason being is that we are fighting over benefits which can mathematically be quantified and are payable over a fixed period of time pursuant to the Long Term Disability policy in place.

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In a recent survey taken by the “Campaign Research Poll” of 506 Toronto voters found that 60% of them wanted cyclists to be licensed and insured. 57% of those surveyed also wanted the City of Toronto to have more bike lanes.

This poll raised significant debate for motorists, cyclists and politicians. Personal Injury Lawyers and insurers got involved as well (as they should).

It should be noted that some of the most serious accident cases which our law firm handles deals with cyclist accidents. It only makes sense. When a bike collides with a car, the car will win! The bike doesn’t have seatbelt, bumpers, anti lock brakes, or air bags to soften the blow. A bike accident is a pure collision of flesh and bone vs. car and pavement. The damage is frequently catastrophic, even fatal.

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When it comes to litigating Long Term Disability Claims, many disabled claimants don’t know where to start.

How do I sue?

Who do I sue?

Can I sue my own insurer?

If I sue, will I get fired?

How much can I sue for?

Will my case go to trial?

If my case settles, how does the settlement work?

How much do I have to pay a lawyer?

All of these are valid questions. The reality about our law firm is that around half of our clients have NEVER consulted with a lawyer, prior to meeting with one of our personal injury lawyers.

To take that statistic to the next level, did you know that over 95% of our clients have have NEVER consulted with a civil litigation lawyer before (a civil litigation lawyer is a lawyer who sues in Court; personal injury law falls under the realm of civil litigation).

The reality is that a great majority of people are not only new to the legal system, they are also new to the concept of having to sue for denied benefits. It’s understanding this reality which makes us perform betters as lawyers and advocates on behalf of our clients.

With that heartfelt preamble, we prepare the latest installment of the Toronto Injury Lawyer Blog in an effort to help others not so familiar with the law, better understand how the legal system works (when it comes to long term disability matters)

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Members of Goldfinger Injury Lawyers attended at a legal conference a few weeks ago. It had all sorts of lawyers, spanning a multitude of different practice areas. It was great chatting with different lawyers outside of the realm of personal injury law to hear about their success stories and struggles. Even though we may have practiced in completely different areas, we managed shared a lot of common ground aside from just being “lawyers“.

In one particular conversation, the lawyers at Goldfinger Injury Law were sharing our stories about the delay in having some of our accident cases heard in a timely matter. Even since the landmark Supreme Court of Canada decision in R. v. Jordan, we were still seeing significant delays on the Civil end of things.

The Criminal lawyers we were sharing that story with looked a bit perplexed. Those lawyers had seen a noticeable push by the Courts to have their cases expedited (even if it wasn’t in either party’s best interest).But when he heard that Court resources were being shifted to the criminal sphere at the expense of other areas (like car accident, disability and personal injury law), those lawyers seemed upset.

One lawyer in particular shared with me that he believed the legal system as we know it was rotting away, seemingly faster every day; and that only the lawyers on the front lines truly understood the decay. With the delays in Court, the lack of judicial resources, the depletion of the legal aid system; only the truly rich and wealthy will have the means to advance their claims, and endure the wait time (and associated legal bills) to have their day in Court.

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Depending on who you ask, Uber is either a fantastic service; or spells the death to hard working taxi drivers. Today, it was announced that the City of Toronto passed legislation which will regulate Uber and other private ride sharing services such that they can operate in the Toronto without further political controversy (we hope).

In case you’ve never heard of Uber before, it’s essentially a taxi dispatch service; only taxi drivers don’t necessarily make the pick ups. The pick ups can be done by every day motorists trying to make an extra buck. Sounds simple enough. The controversy lies in that the taxi regime in the City of Toronto is complex, and heavily taxed/regulated.

In order to operate a taxi, you need to have a special taxi license. These licenses are very expensive, and aren’t just handed out loosely by the City. There are a limited number of taxi licenses around. In addition, licensed taxis have to follow other regulations like how much they can charge per kilometre, what the set base fare charge is, insurance regulations, driver safety regulations, camera regulations etc.

UberX drivers didn’t have to follow any of that red tape. All they needed to do was download the app, and let Uber dispatch them to their next customer for a pick up so they could earn money. It was that easy, and that convenient. The reality was that it was and remains fantastic for consumers. But it undercut hard working taxi drivers who were just trying to earn a living and provide for their families. Fewer fares. Increased competition. Uneven playing field. It was a hard fight and became difficult to compete with effectively cheaper, more convenient and arguably faster and more pleasant Uber service drivers.

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