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Changes to Ontario Accident Benefit Claims are coming …yet again!

It seems that every few months or so, the Toronto Injury Lawyer Blog is discussing the topics to changes in car insurance and accident benefit disputes in Ontario. Is it because we LOVE blogging about accident benefits? Not really. Accident benefits are quite frankly, an incredibly complicated and dense area of the law. The rules for accident benefits, in many respects, are made in favour of large insurance companies and designed to limit an injured claimant’s ability to recover an income. It’s not a committee of accident victims who sit around and make these laws, and tweek them ever so slightly. Rather, it’s deep pocketed insurers and so called “insurance experts” who do so at the behest of the large insurance lobby.

A few quick examples of some arbitrary decisions which accident benefit laws have imposed:

  • No monetary reimbursement for a trip to the doctor which is under 50km. Why 50km? Who picked the 50km distance? Your guess is as good as mine
  • A maximum recovery of just $3,500 for soft tissue injuries which are classified to fit under the Minor Injury Guideline. Why just $3,500? Because that’s what insurers and our government deems to be reasonable. Interesting enough, that $3,500 is less than you paying the full value of your car insurance premiums over a 3 year period in Toronto, London, Ottawa or another large city in Ontario.
  • A maximum recover of $50,000 for claims which aren’t catastrophic, but not Minor. Why a $50,000 limit? Beats me.
  • An income replacement benefit of a maximum of just $400/week under a standard Ontario Automobile Policy, which has NOT increased to reflect inflation over the past 15 years.
  • A deductible which will be increasing from $30,000 to $36,500 for pain and suffering claims. Why $36,500? Beats me.

As you can see, many of the monetary limits imposed in accident benefit law in Ontario are just numbers which seem to be picked out of a hat to favour insurers. Not once have I ever met an injured accident victim, or an ordinary person who believes that these limits are reasonable or helpful for claims.

And yet again, the laws in Ontario are changing. I just love how CAR INSURANCE and accident disputes are such a hot button topic which the government loves to tweek. Don’t they have better things to do? Job creation, education, healthcare, renewable energy sources all come to mind as MORE IMPORTANT THINGS than car insurance. But, the Ontario government is trying to win some cheap points at the expense of the electorate’s accident benefit coverage.

Today, December 9, 2015, Service Ontario released “Proposed Amendments to Insurance Act regulations regarding the Ontario Automobile Insurance Dispute Resolution System (AIDRS)“. Try saying that three times fast. Seriously. That’s the topic of the announcement. You can check it out on the Service Ontario website here.

The biggest proposed amendment is the elimination of the Financial Services Commission of Ontario (FSCO). Instead, they will be moving all accident benefit disputes to the License Appeal Tribunal (LAT). LAT deal with all sorts of things like the Travel Industry Act, Vinters Quality Alliance Act, and the Liquor License Act. It’s a hodge podge tribunal for areas of human life that don’t have a place to adjudicate claims of their own. This change will take place effective March 31, 2016. That’s the last day you can apply for mediation or arbitration at FSCO. After that period of time, it’s all about going to LAT.

Even more significant is that this proposal seeks to eliminate a claimant’s right to have their dispute heard before a Judge and Jury in Court. It takes away their right to a trial.

Who asked for this in the first place? It certainly wasn’t the injury lawyers or their clients. It also certainly wasn’t somebody who knows nothing about car insurance. I have never walked in to a Starbucks or Tim Horton’s, and had a conversation with somebody in line who told me that all they wanted for Christmas was having their right to have their car insurance dispute heard before a Judge and Jury taken away from them. There’s no better gift than the gift of disenfranchisement and having your powers, rights and freedoms stripped from you without you even knowing. Thanks for that.

Let’s be honest. The people who wanted this are the people who run the insurance companies. The logic is that this will help keep their litigation costs down. The promise is that those savings will be passed to the consumer. Do me a favour. If your insurance rates have DECREASED in the past 5 years, please call me and let me know. It would be a provincial news story. If your rates go down after this change, call me as well. This would be another shocker.

Why on earth anyone voting person in their right mind would support such an amendment is beyond me, and beyond most reasonably thinking people who practice in this area of the law. Heck, even for the insurance defence lawyers it means less Court time before Judges. And that’s why we all became lawyers isn’t it. So inmdafstead of having our legal submissions heard before a learned Judge, who went to law school, practiced/studied the law, and who knows their stuff; now we can argue our submissions before part time non-lawyers/non-judges who hear matters deal with bad wine under the Vinters Quality Alliance Act one morning, then hear submissions about bad pay day loans under the Pay Day Loans Act; then hear disputes about car insurance claims and bad faith involving car insurers. Because that’s going to fly really well.

There is a reason why lawyers concentrated in one area of the law. Is it too much to ask that the part time non lawyer adjudicators who will be hearing your disputes at the LAT after March 31, 2016 do the same, much like they did at the Financial Services Commission. I smell disaster. But that’s me. Who knows. It might work out really well. How? Not sure. I suspect that LAT won’t know what hit them when all the mediation files are moved there. But, only time will tell.

Congrats to Toronto’s professional baseball team on now completing the transformation in to the Cleveland Indians. Whatever good will you may have built up over this past year, after 22 years of mediocrity, is going to be flushed down the toilet if some bold off season moves aren’t made. Journey men starters aren’t going to win you the most competitive division is baseball.


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