Articles Posted in Insurance

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We get lots of calls at our law firm from accident victims across Ontario all with the same simple inquiry:

“I’ve been hurt in a car accident. I applied for accident benefits through my car insurance company. And now the car insurance company isn’t paying any accident benefits! Why is that and what can you do to help me?”

Our lawyers do our very best to help every person who calls our office with such an inquiry. We understand that people become very dependent on the benefits which an insurance company provides for them following a serious car crash. An insurer may pay you up to $400/week for an Income Replacement Benefit. They may pay you up to $1,500/month in an Attendant Care Benefit. They may also be paying for your massage, physiotherapy, pain management clinic, psychological counseling, or some other form of treatment which is not covered by OHIP. On the other hand, an insurance company may refuse to pay you anything.

There are plenty of reasons why your accident benefits might not be getting paid. Maybe you’ve changed your address and you haven’t replied to any letters which the insurance adjuster has been sending you? Maybe the insurance company hired a private investigator to take photos/video of you and caught you doing the death walk along the top of Toronto’s CN Tower. Maybe you haven’t even completed the requisite paperwork to get your case started in the first place.
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In a car accident involving pedestrian vs. car; car usually wins. If your name isn’t Superman, then it’s safe to say that the car will knock down and injure the pedestrian time and time again.

The question in pedestrian vs. car accidents isn’t always a question of damages; meaning I got hit by a car now pay me. The question can be hotly contested on the issue liability. That means who’s at fault for the accident. Who is to blame. Is the car driver 100% at fault? Was the pedestrian responsible for the accident, and if so, what percentage of liability ought to rest on his or her shoulders? At law, this apportionment of liability (like dividing up a piece of pie) is also expressed as contributory negligence.

Some of the worst car accident cases which my law firm has ever seen have involved cars hitting pedestrians while they’re trying to cross the road. One of the hardest parts of my job is having to explain the theory of contributory negligence to a client. The more injured the client, the more difficult the explanation becomes (not that every explanation isn’t difficult to begin with).
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You never get a second chance to make a first impression. You parents probably told you this a dozen or so times when you were young. This saying applies as equally to everyday life, as it applies to one’s personal injury case.

Your accident lawyer never gets a second chance to make a first impression on you; the client. It’s in that initial consultation that your lawyer will inform you about your rights, what benefits you may be entitled to; what compensation you may be entitled to; and how your case may progress over time.The lawyer will explain to you how legal fees work, what sort of service you can expect from the law firm, and their action plan for your case. If the lawyer is organized, intelligent, articulate, easy to understand, and likeable, there’s a good chance that s/he will have made a good first impression on the client. The term “likeability” is a term we use a lot at Goldfinger Injury Lawyers on many levels.

The client never gets a second chance to make a first impression on his personal injury lawyer. It’s in that initial consultation the client will inform the lawyer about how the accident happened, the extent of their injuries, the extent of their pain, suffering; and how the accident has changed their lives. Because most qualified, intelligent and empathetic lawyers don’t charge any legal fees until the case settles (which may be years and years down the road), it’s in that initial consultation that the lawyer makes an important business decision whether or not to accept the client’s case. After all, if the client comes off as a liar, a faker, a cheater, a malingerer, or an all around bad person, what reputable lawyer do you think will accept that case and that person as a client. Not many. Again, another reason why first impressions are so important.

But, I will share with you why first impressions are so important in personal injury cases for another BIG reason.
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One of the most important, and most difficult parts of any personal injury case is the Examination for Discovery. In the United States, Examinations for Discovery are called Depositions. The two are basically the same thing.

A Discovery is a chance for the lawyer acting for the insurance company to ask the Plaintiff/Accident Victim all sorts of questions about the car accident, their lives before and after the accident, along with their injuries. All answers are recorded by a court reporter. All answers are given under oath, meaning that you have to swear or affirm your answers to be the truth, the whole truth so help you G-d.

The discovery is likely the first time that the lawyer for the insurance company gets to meet the Plaintiff face to face, and hear them speak candidly about their accident.
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Today Ontario’s Court of Appeal released a landmark decision in Hurst v. Aviva. This decision has an impact on ANYBODY who has been hurt or injured in an accident in Ontario. It relates specifically to accident benefit law, which is a complicated, man made set of laws which gets tweaked every year by the provincial government.

This decision confirms that accident victims deserve timely access to justice when they have a dispute with their own auto insurer over statutory accident benefits.

So, what’s this case all about and why’s it so important? Keep reading and I’ll fill you in!
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As a personal injury lawyer, I get calls all the time from people insisting….swearing….preaching….advocating…yelling at me that they have an AMAZING case that’s so clear cut, only a foolish lawyer would turn the case down.

I often get these sort of calls on long term disabilty cases, and critical illness insurance cases. In case you don’t know, long term disability insurance (LTD) and crintical illness insurance (CI) are both products which you can purchase on your own from a broker, or are benefits through your employer which are to protect you in the event you can no longer work at your own occupation; or in the event you’ve sustained a critical illness such as cancer, or a heart attack. In the case of long term disability insurance, you will recieve a monthly premium which can reflect 75% of your net pre-disability earnings (a monthly benefit). In the case of critical illness insurance, you can recieve a lump sum of up to $1,000,000 depending on how your policy is structured. But, let’s continue on with the stories of those phone calls from people swearing to me that their case is a SURE BET.
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Last week the Toronto Injury Lawyer Blog was in the midst of providing you with valuable tips to complete the OCF-1 Application for Accident Benefits. Now, we’re going to complete this topic on how to properly complete the OCF-1 following a car accident. The fact that it will take 2 (or 3) blog posts to properly complete this topic without rendering you the reader into a coma (likewise to yours truly the writer), should be an indication to you how technical and tedious these forms are to complete.

For your refernce, the OCF-1 Application for Accident Benefits Form can be found on the website of the Financial Services Commission of Ontario here; or at the Goldfinger Injury Lawyers Website in the Accident Benefits section here.
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Today I watched a great clip from Howard Elmer, a contributor to my favourite car television show; MOTORING TV. Motoring TV is on TSN and its a great show about cars, and the people who drive them.

In this clip, Elmer describes how the Insurance Industry is trying to again cap your benefits because the cost of insurance in Ontario is simply too high. There’s also talk about insurance fraud. But, based on my experience, the fraud you see if far less than insurers insist exists, and is a GTA phenomenon. If have yet to see any sort of frauds outside the GTA (Toronto, Vaughan, Mississauga, Brampton). I have yet to sniff or even suspect auto insurance fraud akin to what might exist in Toronto. In any event, this is a great video clip. Here’s the link to the clip. I couldn’t have said it any better myself. Well done Howard.
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Want to learn about the importance of completing an OCF-3 Disability Certificate after your Toronto car accident? Read on.

The OCF-3 Disability Certificate is a form created by the Financial Services Commission of Ontario. Why they created this, along with other silly forms is still a mystery to me, along with personal injury lawyers across Ontario. It all has to do with Ontario’s complicated no-fault accident benefit regime, but that’s the subject of another post.

In any event, following your car accident, your insurance company will send you a booklet of forms. And when I mean booklet of forms, I really mean it. If you don’t like reading, or you don’t like completing standard forms which require a lawyer to understand, then you’ll certainly have issues with these forms. One of the forms is called the OCF-3 Disability Certificate. This is probably the most important and telling form for you to have completed.
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It’s astonishing the number of car accident victims in personal injury cases who come to my law firm unprepared for some of the questions I have to ask them. Basic things like:

1. When did your car accident happen?
2. Do you recall the time of day when the car accident took place?
3. Who was in the car with you at the time of the car accident?
4. Do you recall if the police attended at the car accident scene?
5. Do you recall if an ambulance came to the site of the car accident?

For some people, these questions are difficult to answer, if not impossible due to a brain injury, or the catastrophic nature of their injuries. Some people are unable to communicate given their injuries, or have post traumatic amnesia following their car accident. We see it all the time.
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