Insurance

Published on: June 23, 2021

Car Accident Claim or WSIB Claim? Which route do I choose?

By Goldfinger Injury Lawyers

Car accident law shouldn’t be confusing. But it is!

Workplace injury law shouldn’t be confusing either. But it is!

Part of the reason that both car accident law and workplace injury law are both so confusing is because there are man made laws behind both; which usurp natural law.

For car accident claims we look to the Insurance Act and the Statutory Accident Benefits Schedule. Both pieces of legislation are dense; and require that the injured claimant complete a bunch of confusing standard forms.

For workplace injury claims we look to the Workplace Safety Act, the Occupational Health and Safety Act along with the First Aid Requirements Regulation 1101

These pieces of legislation are also dense, and require that the injured worker complete a bunch of confusing standard forms.

You cannot sue your car insurer in regular Court over an accident benefit dispute for a car accident claim. Instead you must start a proceeding before the License Appeals Tribunal or LAT in the Automobile Accident Benefits Service or AABS

You cannot sue your employer in regular Court over a workplace accident. Instead you must start a proceeding before the Workplace Safety and Insurance Board or WSIB.

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Published on: June 1, 2021

Why WSIB claims and personal injury claims don’t mix

By Goldfinger Injury Lawyers

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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Published on: November 25, 2020

The pros & cons of protected treatment account for a personal injury client

By Goldfinger Injury Lawyers

The cost of Physiotherapy is NOT covered by OHIP. That means that if you need physiotherapy, someone needs to pay for it.

The cost of chiropractic treatment is NOT covered by OHIP. That means that if you need chiropractic treatment, someone needs to pay for it.

The cost of out of hospital occupational therapy is NOT covered by OHIP. That means if you need to see an occupational therapist, someone needs to pay for it.

The same applies to psychotherapy, massage, cranial sacral treatment, nutritionist, a rehab coach, a PSW, an RSW, social work for a car accident case outside of hospital, speech language therapy, neuropsychological testing, driver retraining, case management services, psychology (not to be confused with psychiatry); even some forms of medicinal cannabis for pain management are not covered by OHIP.

All of these services are very important to accident victims for the long roads to recovery following a accident; motor vehicle or otherwise.

If the accident victim has their own form of collateral benefits with an insurer like Blue Cross, Manulife, SunLife, GreenShield, Canada Life etc.; some or percentage of those benefits may be covered. Most policies differ; but it’s not uncommon to see a cap for these services set at around $500 or $750 per year.

If the accident victim was involved in a motor vehicle accident; or an accident arising from the use or operation of motor vehicle s/he will have access to accident benefits to pay for these services.

The level of accident benefits available to each person varies depending on the coverage purchased under the policy along with the degree of injury. For the most minor accidents, people will only have access to $3,500 in benefits. For more serious accidents there is a blended level of $65,000. For the most serious accidents, there is $1,000,000 available in coverage.

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Published on: August 11, 2020

Long Term Disability Claims

By Goldfinger Injury Lawyers

Let me tell you a story.

It’s about an insurance company which deals with long term disability policies.

The size of the insurance company is irrelevant for this story, because most insurers are very similar in their approach. But in fairness, they are not all the same.

The insurance company underwrites thousands and thousands of group and individual long term disability policies.

If the insurance company pays out long term disability benefits on each and every long term disability claim that gets filed; then their profitability as a company suffers.

If the insurance company does not pay out on each and every long term disability claim that gets filed; then they become more profitable.

The more money which an insurance company pays out in benefits; the less money they get to keep and report as profit.

Some long term disability claims are denied for good reason. Some long term disability claims are denied for other reasons which have little merit.

This is where a personal injury or long term disability lawyer comes in to the mix.

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Published on: February 20, 2020

Brian Goldfinger on getting treatment in personal injury case

By Goldfinger Injury Lawyers

After a serious accident or collision, the injured party will require treatment.

Sometimes the treatment is covered by OHIP. Seeing your family doctor, getting surgery, assistance through LHIN, seeing a specialist, publicly funded physiotherapy; these are all examples of treatment which is covered under the OHIP system. That means that regardless of who was at fault for the accident, that you don’t need to pay for the treatment. This type of treatment is of particular important for all manners of accident and injury cases. If you hold a valid Health Card, there is no excuse for not at the very least, seeing your doctor. It’s free.

Sometimes treatment is NOT covered under the publicly funded OHIP system. Seeing a psychologist, a physiotherapist, occupational therapist, chiropractor, speech language pathologist, massage therapist; these are examples of treatment which is NOT commonly covered by OHIP.

To get these forms of treatment which are not covered, accident victims have a few options to access treatment.

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Published on: December 4, 2019

Fire Loss Claims in Ontario

By Goldfinger Injury Lawyers

When it comes to your home, there is nothing more terrifying or tragic than a house fire. All of your possessions, belongings and memories are stashed away in that home. Once it goes up in a blaze, all of those things are gone forever. House fires are devastating for a family.

Fires are also devastating for commercial properties and business owners. Having a businesses’ merchandise and goods lost to fire can completely destroy a company, leaving it’s employees and shareholders in ruins.

People call Goldfinger Injury Lawyers when faced with fire loss. Our lawyers assist families and businesses recoup their losses, and stand up to the insurance company so that our clients get the compensation and peace of mind which they deserve.

The purpose of this Toronto Injury Lawyer Blog Post is to go over the basics of fire loss claims and how to get them started; along with what to expect.

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Published on: September 25, 2019

Long Term Disability Insurance: When your employer under reports your income

By Goldfinger Injury Lawyers

Long Term Disability insurance is based on the basic premise that you are too disabled to work, and that you are insured for a percentage of your pre-disability income. This percentage can vary anywhere from as low as 50% to as high as 80%, depending on the wording of the policy along with the riders contained in the policy.

You know what your pre-disability income was. But your long term disability insurer does not.

Chances are, your long term disability insurer has never heard of you, met you, or hasn’t the faintest idea what you do for a living until you’ve applied for long term disability insurance.

Once you’ve applied, the only way the insurance company has a chance to get to know you is on paper; based on the forms you’ve submitted to them in support of your application for long term disability insurance.

A very important form is the Employer’s Statement, or Employer’s Declaration.

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Published on: July 17, 2019

How Long should my Long Term Disability Benefits Last?

By Goldfinger Injury Lawyers

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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Published on: June 18, 2019

Accident in an Uber? What you need to know from Goldfinger Injury Lawyers

By Goldfinger Injury Lawyers

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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Published on: May 15, 2019

Long Term Disability Claim Tricks and Tactics for Claimants (Ontario)

By Goldfinger Injury Lawyers

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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