Blog – Neinstein Personal Injury Lawyers
Insurance changes put brokers at risk, warn Ontario personal injury lawyers
On June 1, 2016, the Government of Ontario implemented changes to the province’s auto insurance rules “in an effort to comply with a provincial promise to make auto insurance premiums more affordable,” per the CBC. Praised by the Insurance Bureau of Canada, the reforms have been met with hostility by accident victims’ advocates and Ontario personal injury lawyers who say the reforms make it more difficult to access benefits. Now, some experts believe insurers may also be at risk.
Recap: how are injury victims affected?
The June auto insurance reforms resulted in a small – if temporary – reduction in rates, but did so at the expense of injury victims. Under the new regulations, benefits for non-catastrophic injuries were reduced from a combined $86,000 for medical and attendant care to a combined $65,000; benefits for catastrophic injuries were halved, from a combined $2-million to a combined $1-million.
Examples of the impact of the new auto insurance regulations have already begun to emerge. The changes put injury victims at risk and make it harder for Ontario personal injury lawyers to help their clients access sufficient compensation to finance their recoveries.
Insurance brokers also at risk
In addition to reducing benefits, Ontario’s auto insurance reforms transferred accident benefits dispute arbitration away from the Financial Services Commission of Ontario (FSCO) to the new licence appeal tribunal (LAT).
At a recent panel discussion, Resort to the LAT or Last Resort, legal experts discussed the impact this shift might have on the auto insurance industry, including a heightened risk of lawsuits against brokers.
In Ontario, drivers must carry a minimum limit of $200,000 in third-party liability coverage, a figure which Thomson Rogers partner Wendy Moore Mandel said “was set so long ago, that it’s really no longer relevant,” Canadian Underwriter reports. That $200,000 limit is intended to pay for claims that stem from lawsuits against the policy holder. However, because accident benefits have been so steeply reduced, more accident victims are likely to initiate civil lawsuits in hopes of accessing funds for their recovery, and many of those claims will be well in excess of $200,000.
Accident victims with “a valid tort claim” aren’t going to go through the LAT procedure if “there is enough coverage on the tort side,” Moore Mandel explained.
The new LAT process, said Jim Vigmond, ex-president of the Ontario Trial Lawyers Association (OTLA), “offloads everything to the tort system and until we get those (third party liability auto) limits up, that’s going to be a big problem.”
Both Vigmond and Moore Mandel believe insurance companies’ failure to educate their clients on the need for higher benefits policies and higher third-party limits could lead to lawsuits against brokers.
“There will be a lot more claims against insurance brokers,” Vigmond said. “I think we are going to see greater incidence of those claims driven not only by the facts but the need to find another deep pocket.”
Sam Pitaro, a partner at Pitaro Romeo Schneider Injury Lawyers, also sat on the panel. He believes that since June 1, it has become necessary for brokers to supply “a rigorous set of instructions … to a potential insured” explaining how to purchase additional coverage, and why it is necessary. By paying as little as $35 extra per month, Pitaro explained, insureds can “essentially reinstate the $2million catastrophic” coverage.
What can Ontario personal injury lawyers do to help accident victims
If you or a member of your family is injured in an automobile accident, you should immediately contact an experienced attorney. The accident benefits and auto insurance systems are complex environments that are best navigated by a dedicated professional. With the help of Neinstein’s team of Ontario personal injury lawyers, you may be able to access the compensation you need for a successful recovery.
How can Ontario’s cities reduce cycling and pedestrian fatalities?
Toronto is grappling with an almost unprecedented wave of traffic fatalities. With more than a month remaining in 2016, more than 70 people have already been killed on the city’s roads, eclipsing last year’s mark of 65, an 11-year high. More than half of this year’s road fatalities were vulnerable road users, including 36 pedestrians and at least one cyclist. With commuters heading home in darkness and inclement weather on the horizon, it’s reasonable to believe the death toll will climb higher before the beginning of the New Year. read more…
Accident Benefits & Driving without Insurance
Although the government insists that our insurance rates are going down we are all quite aware that this is not the case. Regardless, when you own an automobile in Ontario it is mandatory to have it insured. But what happens when someone decides not to insure their vehicle, or to purchase a fake pink slip, or to not pay their premiums and let their policy lapse?
Driving without insurance is simply a bad idea on all fronts. However people may be surprised to learn that even when you drive without insurance your accident benefits are not totally barred. read more…
Attendant Care Since February 1, 2014
Section 2 of Ontario Regulation 347/13 came into force on February 1, 2014. The regulation states that the monetary value of attendant care provided by a family member is limited to that family member’s economic loss. Davis v Wawanesa, is a recent case which determined that this provision should not be applied retrospectively.
In this case, the motor vehicle accident happened before the Regulation came into force, but the claim for attendant care services was made after the Regulation was enacted. The Plaintiff argued there should be no cap on AC benefits because the accident occurred prior to the Regulation becoming active.
The Regulation does not delineate whether it applies to accidents that occurred before its enactment. Justice Quinlan reasoned that because there was no clear legislative language stating otherwise, the law that applied was the law that was in force at the time of the accident. Consequently attendant care benefits were not capped at the amount of economic loss of the family member providing the AC.
Insurer faces backlash after refusing accident benefits payment to injured girl
Last week, the CBC reported that Industrial Alliance, Canada’s fourth largest insurance provider, had refused to pay out benefits for 12-year-old Emily Laprise of British Columbia, who suffered a traumatic eye injury during a soccer game. Laprise suffered a detached retina, which a surgeon was able to repair, and tear in the retinal lining of her left eye, which remains. Emily has lost most of her lower field of vision, and sees double.
If you or a member of your family has been injured in an accident, contact an insurance disputes lawyer today. Accident insurance is notoriously difficult to access, even for loyal clients, as Emily’s story illustrates.
According to Emily’s mother Nancy Desrosiers, a former emergency room nurse who has seen serious injuries impact numerous peoples’ lives, Industrial Alliance refused to pay accident benefits because Emily “does have some sight” in her left eye. A clause in Desrosiers’ policy states that in order for her to qualify for benefits, Emily would have to have “a corrected visual acuity of less than 20/200,” meaning she would not be able to see at 20 feet what someone with 20/20 vision would be able to see at 200 feet. Without glasses, Emily fits this description, but because strong prescription glasses can eliminate blurriness, Industrial denied coverage.
“I was blown away,” Desrosiers told the CBC. “After 12 years of paying for insurance? I was going, ‘I can’t believe this.’”
“Nowhere in the policy does it say, ‘by applying glasses’ the policy is no longer applicable,” Desrosiers continued. “To me, ‘corrected vision’ means if you can correct it with surgery, and get it back. She never needed glasses before, but now if she doesn’t wear them, she sees double and there’s still parts that are black.”
“In any living benefit insurance policy – and accident insurance is one – the policies are limited by the definitions they use. There’s a lot of grey area,” independent insurance broker Lorne Marr told MoneySense.com. “You may have breast cancer, for instance, but you may need to specifically have Stage 4 breast cancer for the policy to pay out.”
This variety of ‘grey area’ is a common theme in accident insurance policies, as any insurance disputes lawyer can tell you. In their report, the CBC talked to several critics who believe accident insurance ‘isn’t worth buying.’ Vancouver personal injury lawyer Scott Stanley compared accident insurance to “playing a slot machine that … never pays out.”
“A really good example is with minor hockey policies,” Stanley continued. “They pay out if you lose your hand. I’ve never heard of that. You might lose a finger or tip of a finger, but not a hand. So in a way, they are engineered to never pay out.”
Alex Saltykow of Insureye, an insurance industry watchdog, said accident insurance leaves “room for interpretation of policy definition and claim qualification. Insurance policies are worded in very deliberate, clever ways. Insurance companies need to explain to people more clearly what their definitions are.”
While an experienced insurance disputes lawyer may have the necessary expertise to navigate insurers’ complicated policies, the average citizen does not.
More than half a million people read the CBC’s report, and public outrage has led Industrial Alliance to reconsider its position. The insurance provider and Desrosiers came to “a mutually agreeable solution,” that Desrosiers said she is “very comfortable with.” Emily will also have access to $15,000 from the BC Soccer Association’s sport accident policy.
If you or a member of your family has suffered an injury and is engaged in a dispute over insurance coverage, contact an insurance disputes lawyer at Neinstein Personal Injury Lawyers today for a free, no-obligation consultation.
Seatbelts, cellphones, and automation: how can Ontario’s drivers stay safe on the road to driverless vehicles?
Photo credit: State Farm/Flickr
Human error, according to a multitude of sources, is primarily to blame for the majority of car accidents on North American roads. The U.S. Department of Transportation has stated that “the critical reason, which is the last event in the crash causal chain, was assigned to the driver in 94 percent of the crashes,” while the Eno Center for Transportation said, slightly more conservatively, that “driver error is believed to be the main reason behind over 90 percent of all crashes.”
While an experienced car accident lawyer will not be surprised by these statistics, they may come as a shock to many drivers/ Still. experts like Ryan Hagemann, a fellow on robotics at TechFreedom, believe that increasing and improving automation in private vehicles could significantly reduce accident rates.
“In theory, if you have 100 percent fully autonomous vehicles on the road, while you still might have accidents on the margin in rare situations, you’re basically looking at anywhere from a 95 to 99.99 percent reduction in total fatalities and injuries on the road,” Hagemann told Tech Times.
The automotive industry is steadily introducing new technologies and features to their vehicles which are stepping stones on the road to full automation. Today’s cars are more automated than ever, but improved technology has yet to translate into accident- and fatality-free roads, and human error is still to blame. If you have suffered an injury in an automotive accident, contact a Neinstein Personal Injury Lawyers car accident lawyer today.
Ontario Provincial Police Annual Seatbelt Blitz
Take as an example the Ontario Provincial Police’s (OPP) annual seatbelt blitz, conducted between September 21 and October 7, 2016.
The OPP laid more than 4,250 charges during this year’s seatbelt blitz, down approximately 1,200 from 2015. Fatalities have also fallen to 45 from 49 a year ago, Driving.ca reports. Alberta police report similar trends, including a 20 per cent drop in charges from last year.
Despite modest improvements, though, law enforcement still struggles to convince drivers use their seatbelts. This is particularly true for 24- to 35-year-olds of all genders; males in that age range account for about three-quarters of all seatbelt infractions and deaths.
“The seatbelt law went into effect 40 years ago,” OPP Spokesperson Sergeant Kerry Schmidt told Driving.ca. “This is not a generation who has ever known anything else.”
As automation increases, drivers are paying less attention to safety basics
Distracted driving has become an even greater concern to law enforcement and each car accident lawyer than seatbelt compliance. Alberta Staff Sergeant Paul Stacey told Driving.ca: “We’re seeing increases in the U.S. and the U.K. and we’re trying to stop it, but it’s a tough battle. One of our members was hit while on a motorcycle; the motorist’s response? ‘But my lane departure light didn’t go off.’ We’re seeing a decrease in things like shoulder checking.”
In terms of safety basics, shoulder checking is essentially on par with seatbelt use: both take little effort, and both can save your life. But as cars become safer, drivers may be more likely to forget the little things that keep them safe.
“There’s nothing worse than being a first responder and finding someone has been ejected,” said Schmidt. “The safety cage is intact, the car did its job, all those safety features someone probably bought that car for, fatally negated.”
Auto manufacturers and global tech companies like Google and Apple are well on the way to developing truly autonomous vehicles that will greatly improve road safety across North America. However, until driverless cars become a reality, Canadians must continue to abide by basic safety rules like shoulder-checking and buckling up if they want to ensure their roads are safe.
If you or a member of your family has been injured in an automotive accident, contact a car accident lawyer at Neinstein Personal Injury Lawyers today for a free, no-obligation consultation. You may be entitled to compensation.
Extended Health Care Benefits & their interplay with Accident Benefits
If you are one of the fortunate people who have coverage for extended health benefits through employment, spouse’s employment or parents’ employment this information is for you.
Once you are injured in an accident and proceed with an Accident Benefits claim you will likely be referred for some type of therapy. If you do not have any extended health benefits and only O.H.I.P. coverage, your physiotherapist, for example will invoice your Automobile insurance company directly for full payment. However if you do have extended health benefits, your therapist must bill this policy first with the balance going to your Auto Insurer.
Example:
Jim is involved in a serious motor vehicle accident. He sustained various injuries. His family doctor refers him to physiotherapy, massage therapy and recommends several devices to assist him at home.
Before the accident Jim was a stay at home dad and his wife worked at a bank. He had extended health benefits coverage (“Policy A”) through her policy. He submits an application for Accident benefits to his own automobile insurer (“Policy B”).
The physiotherapy, massage therapy and devices would first be billed to Policy A, even if Jim is uncertain they will be covered. Policy B will not issue any payments until Policy A responds in writing that they are not paying or that they have paid out what is covered.
Many injured people find it unfair that their own personal extended health benefits are utilized when their injuries are as a result of an accident. Unfortunately the law states that if an injured party has extended health benefits these must be used first.
It is best to be familiar with your coverage and be aware of what your rights are. As Accident Benefit coverage decreases finding any way to access additional coverage will be helpful in your recovery.
Citizens and car accident lawyers greet new Ontario drug-impaired driving laws
Credit: Michael Gil/Flickr
Drug-impaired driving is on the rise in the City of Toronto. On September 22, the CBC reported that ’58 drivers have been charged with impaired driving connected to drugs so far this year, compared to just 19 at this same time last year.’ Like drunk driving, drug-impaired driving puts all road-users at serious risk of injury, and though car accident lawyers and rehabilitation workers can provide important resources to injury victims, life after a traumatic injury may never be the same. read more…
Ontario feels good about auto insurance reforms. Do drivers and accident benefits lawyers agree?
Photo credit: George Socka/Wikimedia Commons
On September 23, the Insurance Bureau of Canada (IBC) issued a press release congratulating the Government of Ontario for ‘continuing to make auto insurance reforms a priority.’
“The government’s continued focus on auto insurance reforms builds on the progress already made and shows a strong commitment to helping Ontarians keep more of their hard-earned money for other household priorities,” said IBC President and CEO Don Forgeron, in the release. “Insurers look forward to continuing to work with Premier Wynne, her government, and all MPPs to best serve the consumers of this province while making their lives more affordable.” read more…
How medical evaluations impact Ontario’s insurance and accident benefits systems
Photo credit: maveric2003/Flickr
In 2006, it was revealed during testimony for Macdonald v. SunLife Assurance Company of Canada that a doctor’s medical report had been rewritten by the clinic which had brokered it on SunLife’s behalf. Ten years later, not much has changed, and Macdonald is a familiar touchstone in arguments against Ontario’s troubled auto insurance and accident benefits systems.
Independent medical evaluations (IME) are common in insurance claims lawsuits. In an ideal world, medical experts would be brought in to provide unbiased evidence on the accident victims’ injuries. But according to Toronto lawyer Loretta Merritt, procuring a genuinely impartial medical evaluation has become a costly and complicated endeavor, and assessment clinics are part of the problem. read more…
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