Articles Posted in Insurance

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When a police officer asks us a question, we’re taught to do our very best to co-operate. Why wouldn’t we want to co-operate with the authorities and help them do their jobs.

When I was young, we were taught in school to answer questions as best as we can. We weren’t very concerned with issues of fraud or breach of privacy as we are today.

Those hard and fast principals go out the door in a legal context.

In a legal setting, when you’re asked a question, you had better make sure that your answers aren’t going to hurt your case, or stop your case from proceeding before it’s even had a chance of getting off the ground.

These warnings don’t apply as much with authorities such as the police, as they would with insurance adjusters.

You would be amazed at the amount of personal and confidential information which accident victims freely give up to insurance companies over a simple phone call or during a simple statement.

After you’ve been involved in a serious car or motorcycle accident, it’s pretty safe to say that either one of the parties or the police will report the accident to the parties’ respective insurance companies.
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The idea behind Critical Illness Insurance sounds great.

If you suffer from a particular critical illness, then the insurance company will pay you a lump sum.

What sort of critical illnesses are covered are defined by the policy.

It all sounds great, and sounds like a very lucrative proposition. For many, this sort of insurance bets AGAINST your very own health. People think that if they sustain a heart attack, then they’ll be entitled to a lump sum under the policy. So, eating that hamburger and skipping that workout might actually pay out in the long term if your critical illness policy works the way you think it works.

Unfortunately, many of these policies don’t work they way that you think they work, or the way that the broker who sold you the policy explained it to you.
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You know what’s fun?

Posting status updates on Facebook.

Posting pictures on Instagram.

Posting videos on Vine.

Posting your day to day thoughts on Twitter.

Posting your new job on LinkedIn.

Social media is FUN.

But just because something is fun or popular, doesn’t mean that it’s right for you, particularly when you’re in the middle of a litigation battle against a large, deep pocketed insurance company.

The purpose of this Toronto Injury Blog Post is to show you how insurers can and WILL use social media against you to defeat your credibility and to defeat your personal injury case.
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Hey Brian! As a lawyer, you must hear some crazy stories. (TRUE).

You probably have lots of strangers calling you every day, wanting to discuss their legal problems (TRUE).

What are some of the most commonly asked questions of you (GOOD QUESTION).

As an injury lawyer, we hear of, and see lots of crazy things; lots of sad things; and lots of things that you just can’t make up. Some of these stories, I’m not at liberty to share with the general public.

Regardless of the severity of the injury, one thing that ties most clients together are their questions and concerns for their respective cases. From Toronto to London to Peterborough, client questions are generally the same. Just shows you that geography, race, culture, creed; it doesn’t really matter. People are people, and they share many commonalities regardless of your background, upbringing, or the mechanism and nature of the injury.

So, without further a due, here are some of the most commonly asked questions we here from inquiries to Goldfinger Injury Lawyers.
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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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This week’s entry comes straight from the Toronto Injury Lawyer Blog reader mailbag.

Question: Goldfinger: Love the Blog. Hate the new head shots. But seriously, my wife and I are looking at getting insurance. You know. We were curious about life, disability, critical illness etc. You see it all. What should we be looking out for when buying our insurance. Best Regards JJ + PJ
Well JJ and PJ, thanks for your question. Always nice to hear from our readers.

NOTE: Lawyers don’t sell insurance. We sue insurers after they’ve denied your claim.

For starters, buying insurance is not an easy decision. For starters, I could count of a million things more exciting than insurance to spend your hard earned dollars on. On top of that, insurance can be expensive.

Secondly, have you ever read an insurance policy? They’re long, boring, and very difficult to understand. You really need to be a lawyer to truly understand what they’re trying to say. And even then, some clauses and and definitions contained in those policies are subject to one’s interpretation. Any ambiguity contained in a policy will be interpreted in your favour: BUT: do you really want to have to retain a lawyer and fight in Court for years and years over benefits, when you could have just saved the trouble and hassle and received them now? That’s just a big pain in the you know what; not to mention all of the unnecessary stress and anxiety which might come with involved in being in litigation with a large deep pocketed insurance company. Hey: sometimes it’s necessary. That’s what we’re here for.

Here are a few tips I’ve learned from litigating life insurance, disability insurance and critical illness insurance policies throughout the years.
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It’s an unscientific fact that insurance companies don’t like fibromyalgia claimants. It makes no difference of the context of that fibromyalgia claim. It could be for your short term disability claim, long term disability claim, slip and fall or car accident.

Don’t take it personally. It’s not YOU they don’t like. It’s your symptoms, injuries, and what they stand for.

Here’s the harsh reality about fibromyalgia. It won’t show up on an x-ray, CT scan, MRI or any other fancy objective scan. There are trigger points but those don’t show up on computer tests. Insurance companies LIKE those sort of tests. It puts your injuries in to a black and white context. If it’s there on the scan and visible to the naked eye on a computer screen, then you have it and you’re likely suffering from it. If your injury doesn’t show up on the scan, then it doesn’t exist. It’s probably a figment of your imagination, or a way for you to lie in your attempt to deceive the insurance company.

It makes it much easier for an insurance company to lump your claim in to a simple formula that an unskilled, and untrained adjuster can follow. If the claimant has an ankle fracture, then he/she is entitled to “X” amount of dollars. If the claimant has a broken femur then he/she is entitled to “Y” amount of dollars…And so forth. I hope you get the picture.

The moment that your injuries cannot be put in to a simple mathematical and easy to understand equation is the moment that the insurance company needs to think and take a better look at your claim. When the insurance company has to slow down its operations for your claim, it hampers their productivity and profits. This is NOT good for their business.

The problem is that fibromyagia cannot be put into a simple mathematical equation and cannot be looked at from a “black and white” perspective. There’s a lot of grey area when dealing with these types of claims.
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Our office’s Toronto Injury Lawyer Blog has been a huge success at educating the general public about how car insurance works, how the Courts work with respect to personal injury claims, and all sort of other helpful information for accident victims, disability claimants and their families.

Our law firm prides itself on using easy to understand language to get the message across. We know that not everybody is comfortable reading hard to understand legal terms or “legalese” as we call it.

This has been a big week for car insurance law in Ontario. So much of the law involves politics. Believe it or not, politicians through our government create the laws we live by.

We vote for politicians, who in turn, have the power to make, break, or change laws. We often write about politics in the Toronto Injury Lawyer Blog because decisions made at Queens Park have a major impact on personal injury law.

A few months ago, the Provincial Government introduced some radical changes to the Insurance Act. This is the piece of legislation which deals directly with how car accident law, and accident benefit law works. The changes were brought in very quickly, without any prior notice or debate. They were just passed through without the general public really knowing. You can read our previous blog post here posted on December 18, 2013.
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While Canada was glued to their TVs watching Latvia play their version of a prevent defence in American Football, or an ultra conservative soccer defence, another story creeped up which caught my eye.

Today’s front page of the Globe & Mail had a story about Canadian Doctors being urged by 8 medical societies to reduce medical tests in order to save money.

Here is a copy of that Globe & Mail article.

The gist of this article states that Canadian doctors are wasting their time and money on unnecessary tests. All of these tests are a burden to the Canadian health care system. Imaging for complicated headaches, and lower back pain are seen as some of those unnecessary tests. Treatment for “minor” head injuries is also on the list. Just ask Sidney Crosby. No head injury is minor.

Tell that to some of my car accident and chronic pain clients. It would likely make them sick to their stomachs. Ever wait for an MRI? The wait period is months long (unless you get really lucky), and the time you get is very firm. Miss it, and you’re sent back to the bottom of the wait list. Months and months more of waiting around. The best is when they call you in for an MRI at 2AM or some other absurd time.
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We receive many calls every week from people who have been denied their Long Term Disability Benefits, by private disability insurers such as Great West Life, SunLife, Manulife, Standard Life, Industrial Alliance, SSQ, Co-Operators, Empire Life, RBC Insurance and others.

People want to know what to do after they’ve been denied.

Denial, or termination letters are often lengthy detailed letters which include the provisions of your LTD policy, the definition of the term “disability” based on the policy, excepts from medical records or medical reports, along with the insurer’s reasoning to deny or terminate benefits.

After these long winded reasons are provided, the insurer will also then include ways that you can appeal their decision. Statements like you have 90 days from the date of this letter to appeal this decision through our Appeals/Investigation Committee are common. People call our law firm in an absolute PANIC stating that they’re under the gun and that their opportunity to appeal the claim is fast approaching.

What I tell these people is NOT TO WORRY, and NOT TO PANIC. These internal reviews or internal appeals are often a waste of time and energy. Here’s why Continue reading →

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