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The personal injury lawyers here at my law firm, Goldfinger Injury Lawyers have developed a unique term for certain long term disability cases.

We call it getting “mathed out“.

What does it mean to get “mathed out“? It means that the math is working against you to defeat your claim, regardless of the merits of your disability.

Let’s explore how long term disability cases work.

These are cases which are based in contract. That contract takes the form of an insurance policy. Often we see our claimants with group policies, which contain sections for health, dental, life, and long term disability insurance. These group policies are a perk of employment (a benefit). Had the person not been gainfully employed, they would not have been covered under the policy; hence they would have no cause of action.

Some employees don’t have any benefits whatsoever, so if they don’t have their own personal long term disability insurance, they won’t have a cause of action.

On one hand the claimant needs to be thankful that they have a policy or long term disability coverage to lean on. But on the other hand, many claimants get upset that the policy seems to work in favour of the insurer and not the other way around.

The wording contained in these policies is written by large insurers. Because large insurers write the policies, you can expect that they contain a lot of favourable clauses protect their own interests and not yours. Why would you expect an insurer to draft a policy that doesn’t work in their favour? We just don’t see this sort of thing.

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Brain injury is right up there with the most serious injury one can get in a bad motor vehicle collision, or accident not caused by motor vehicle collision.

The thing about brain injury is that it can often be overlooked, or misunderstood by the general public, or even doctors.

The notion that you aren’t in a wheelchair, without any visible injuries so therefore you’re “ok” is wrong; yet still fairly popular. Even with increased public awareness campaigns along with concussion recognition protocols that we see in sport (football, hockey); there remains a pervasive attitude that one must “suck it up” and deal. This is particularly popular in an old school Canadian hockey culture that a few bumps or knocks to the head should not keep you on the sidelines.

Not only is brain injury invisible to the naked eye, there is still a lot we don’t know about the brain along with how brain injuries impact one’s body, mind and soul.

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Summer long weekends can bring out the best, and worst in people.

As a personal injury lawyer, we are consulted in situations where bad things happen. Often bad things happen to very good people. This can have a devastating impact on the lives of the injured party, along with the lives of their families and loved ones. The future of one’s life can be altered for the worst in an instant thanks to some bad decisions.

Our law firm helps people from across the province of Ontario get the compensation they deserve. But Brian Goldfinger has seen far too often that the laws to compensate innocent accident victims, particularly in car accidents aren’t fair.

  • There is a secret credit for each car accident case whereby the first $38,818.97 for every award under $129,395.49 vanishes! That means if a Judge or Jury awards you $40,000 in damages for your pain and suffering in a serious car accident case which isn’t your fault, that $38,818.97 is subtracted from that amount leaving you with only $1,181.03! If a Judge and Jury award you $35,000, you are left with ZERO after the $38,818.97 deductible is applied. At law it’s called a deductible, but in reality, it’s a secret credit
  • Your personal injury lawyer CANNOT mention the aforementioned secret credit to the Jury at trial and the majority of people and juries alike don’t even know that a deductible applies which contemplating awards for car accident cases.
  • If your personal injury lawyer mentions the deductible aka secret credit, a Judge may declare a mistrial and seek that the Plaintiff and his/her personal injury lawyer pay costs to the defendant.
  • The will of the jury is usurped by the law when the deductible aka secret credit is applied. If a jury intends to award a Plaintiff $50,000, they should get the $50,000 award as the jury intended. But instead, the will of the governments supersedes the will of the jury which sat through the evidence and heard the case when the deductible is automatically applied.

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If you’ve been involved in a serious car accident, the police will generally come out to investigate the accident and lay charges on the at fault driver, if necessary.

At the scene of the car accident, police officers are required to take notes. Some officers notes are more detailed (and legible) than others. The police officers may also prepare an accident report at the scene of the collision, or back at the station. Those officers may (or may not) give you a copy of the accident report on the scene. Or, it may be provided to you at a later date (at a charge).

The motor vehicle accident report, or the police report as it’s commonly called, is the building block for proving liability in any personal injury car accident case.

This is the starting point for personal injury lawyers, insurers, defence lawyers and judges to understand how the accident happened.

The police report provides what’s supposed to be an objective synopsis of what happened.

Let me be perfectly clear. Sometimes the police don’t get it right. Their intentions are in the right place, but we are all human and we make errors. It happens.

Unfortunately, when these errors in reporting the collision happen, it can have a significant impact on the personal injury case.

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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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If you have been hurt or injured in a car accident in Ontario, you may be entitled to an income replacement benefit of up to $400/week (or more if you paid an additional insurance premium to increase your IRB level).

$400/week isn’t very much money. But before you complain, all Ontario drivers are eligible to purchase optional benefits to increase the IRB level. Unfortunately, very few Ontario motorists opt to purchase this coverage because it tacks more money on to their existing premium. Let’s be honest, the majority of people are simply looking for the cheapest rates around, without giving much thought to what they are, or aren’t covered for and regardless of the ultimate benefit which is paid out.

If I told you that you could increase your liability coverage from $1,000,000 to $2,000,000 per year by paying an extra $20/year, would you take it? Sounds like a pretty good deal right? Paying just $20/year for an extra $1,000,000 in coverage. This is one of the best bangs for the buck on the car insurance market, but few people opt for this additional coverage benefit. The cheapest coverage is the default coverage of choice for the majority of Ontario drivers.

When you think of the term income replacement benefits, it would lead you to believe that the benefit will replace your entire income for the period you’re too injured to work following a car accident. NOT TRUE.

The term income replacement benefit is somewhat misleading, as it doesn’t entirely replace your income, and it’s not as automatic as the term “benefit” would lead you to believe.

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It’s hot. That means more people are outside doing “outdoorsey” stuff like hiking, cycling, rollerblading and skateboarding.

The activities are suppose to be fun and safe. But sometimes things can go wrong. And when they do, our law firm usually hears about it.

Accidents whereby skateboarders, cyclists and rollerbladers are hit by cars are usually very serious. Want to know why?

The average weight of a large car is over 4,000 pounds! The average weight of a Canadian male is 177 pounds.

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One of the most common orthopedic injuries our personal injury lawyers see in slip and fall cases are broken ankle.

Not sprained. Not bruised. Broken ankles. Like the ankles when you fall you may hear a snap, crackle or pop; but in a bad way and not in the breakfast cereal type of way.

A broken ankle injury is very serious. Think about it for a moment.

When you stand, pressure is applied to your ankle.

When you walk, your ankle needs to flex. When you rotate, jump, bend, kneel; all of these movements puts pressure and strain on your ankle.

If your ankle goes in to a hard plaster cast, you’re out of commission. You can’t walk, run, or jump. Your doctor will recommend that you are non weight bearing. That means you’re not to put weight or pressure on your ankle. Translation: no walking or putting pressure on the ankle. Or if you are getting around, you will need to do so with crutches, a wheelchair, or one of those scooters you may see that allows you to raise an ankle while rolling around.

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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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Everyone loves a good acronym. It’s fun to guess what the letters in the acronym stand for…..or don’t.

Here are a few non legal examples:

BRB Be right back

GTG Got to Go

LOL Laugh Out Loud

Here are a few legal examples of acronyms which personal injury lawyers in Ontario see everyday:

IRB Income Replacement Benefit

NEB Non Earner Benefit

SOC Statement of Claim

ACB Attendant Care Benefit

Here is one acronym which has been in use for over 20 years in legal circles which will soon go extinct:

FSCO Financial Services Commission of Ontario

The Financial Services Commission of Ontario is a regulatory agency of the Ontario Government that use to regulate insurance, pension plans, loan and trust companies, credit unions, caisses populaires, mortgage brokers, and co-operative corporations in Ontario. FSCO regulated or registered:

  • 316 insurance companies
  • 7,022 pension plans
  • 98 credit unions and caisses populaires
  • 57 loan and trust corporations
  • 1,216 mortgage brokerages
  • 2,754 mortgage brokers
  • 12,275 mortgage agents
  • 184 mortgage administrators
  • 4,630 accident benefit service providers
  • 1,764 co-operative corporations
  • 54,128 insurance agents
  • 5,911 corporate insurance agencies
  • 1,740 insurance adjusters 

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