The Liberal government has released the budget for the 2015-16 fiscal year indicating the following changes relevant to the auto insurance industry:
– Combining attendant care benefits into the medical rehabilitation benefit category while increasing this category from $50,000 to $65,000 (currently attendant care is separate category at $36,000);
– Combining attendant care into the $1,000,000 catastrophic medical and rehabilitation benefit category (currently people with catastrophic injuries have $1,000,000 in attendant care benefits and $1,000,000 in medical and rehabilitation benefits);
– Reducing the standard duration for medical and rehabilitation benefits from 10 years to 5 years;
– Eliminating the 6 month period for non-earner benefits while putting a cap on their duration to a maximum of 2 years from the accident;
– Changing the catastrophic benefit definition to be “consistent with more up-to-date medical information and knowledge” ;
– Requiring goods and services not listed in the Statutory Accident Benefits Schedule to be “essential” and agreed on by the insurer;
– Increasing the deductibles on court awards for general damages for pain and suffering (currently $30,000 for awards under $100,000);
– The tort deductible to be taken into account when determining a party’s entitlement to costs in an action for damages from bodily injury or death (currently a party’s entitlement to costs is calculated on the gross amount).
Less than 5 years ago, the Ontario government made significant reductions to accident benefits including reducing med-rehab benefits from $100,000 to $50,000 and attendant care benefits from $72,000 to $36,000. In addition, the Ontario government also reduced mandatory income replacement coverage (from 80% of net income to 70% of gross income) and introduced the minor injury guideline which imposes a $3,500 cap for injuries that fall under this guideline.
Despite these reductions, according to a study commissioned by the Ontario Trial Lawyers Association (OTLA), Ontarians likely have overpaid auto insurance by about $3.1 billion between 2001 and 2013. The study found premiums have been too high, and consumers in Ontario have been paying too much for auto insurance. They also reported that insurers made on average 12% return on equity in 2014 alone. The most recent changes are made under the guise of reducing premiums and reflecting inflation. However, there does not appear to have been much discussion about insurer profits or premium reductions prior to the government’s decision to reduce even further standard benefit coverage. With respect to inflation, it should be noted that Income Replacement Benefits have not changed from the amount of $400 per week in 25 years. What is clear is that the recent changes will undoubtedly have a further negative impact on the seriously injured accident victims.
Virk Personal Injury Law’s Freda Vanopoulos is co-hosting the upcoming 29th ANNUAL JOINT INSURANCE SEMINAR presented by the Hamilton Law Association & The Ontario Insurance Adjusters’ Association.
The seminar will provide personal injury lawyers and insurance adjusters a unique opportunity to network while picking up tips and updates on developments and emerging issues in personal injury law.
Don’t miss this event scheduled for THURSDAY, APRIL 30th, 2015 – 8:00 a.m. to 3:30 p.m. at the Hamilton Convention Centre, Chedoke Room (1 Summers Lane, Hamilton)
And obtain more than half of your annual CLE credit requirements as this program contains 1.75 Professionalism Hours and is also eligible for up to 4.75 Substantive Hours.
For more information on the event or to register, visit the Hamilton Law Association website: http://www.hamiltonlaw.on.ca/
Bal Virk is a proud member of the Board for Camp Dawn. #CampDawnON provides a rare opportunity to adults with acquired brain injuries to participate in the full camp experience! Camp Dawn has grown tremendously over the years from 19 campers and 11 leaders when it started in 2003 to now host 100 campers and over 40 leaders! You can read Campers’ experiences on the Camp Dawn Facebook page.
The cost of providing camp to our campers is approximately $40,000 and the charge to campers is only $150. We also provide transportation from 3 locations to camp.
Camp dawn relies on our sponsors and donations to make camp accessible to our campers.. Consider making a donation or becoming a leader at campdawn.ca or see http://bit.ly/1zTUTUT for the benefits of sponsorship!
Get your ticket today for the 2nd Wine tasting and silent auction on March 26th. There are some sponsorship opportunities available for this exciting event.
Stay tuned for updates and show your support on Facebook and Twitter @CampDawnON.
The Court of Appeal in Moore v. Getahun  O.J. No. 398 has recently provided clarity as to whether lawyers can review draft expert reports and what is the appropriate degree of consultation between a lawyer and a testifying expert?
The issue arose in a medical malpractice case. The Court of Appeal for Ontario concluded that the trial judge erred in holding that it was unacceptable for counsel to review and discuss the draft expert reports with their expert witnesses. According to Justice Sharpe, there was no basis for disturbing the well-established practice of counsel meeting with expert witnesses to review draft reports to ensure reports were framed in a comprehensible and responsive manner with respect to the relevant legal issues in a case.
Justice Sharpe emphasized that counsel play “a crucial mediating role” by explaining the legal issues to the expert witness and then by presenting complex expert evidence to the court. This would be difficult to achieve without engaging in communication with the expert as the report is being prepared.
Justice Sharpe also identified existing safeguards against the concern that permitting counsel to engage in an undocumented review and discussion of draft expert reports may interfere with the impartiality of expert witnesses. For example, cross-examination is an effective tool to deal with cases where there is suspicion that counsel may have improperly influenced an expert witness, and it is in the judge’s discretion to reject or limit the weight to be given to the evidence of an expert witness where there is evidence of a lack of independence or impartiality.
“Leaving the expert witness to his or her own devices, or requiring all challenges to be documented in a formalized written exchange, would result in increased delay and cost in a regime already struggling to deliver justice in a timely and efficient manner”, Justice Sharpe noted.
With respect to documentation and disclosure of consultations regarding draft reports, according to Justice Sharpe, subject to certain exceptions, litigation privilege attaches to draft reports, notes and records of consultation between counsel and expert witnesses. Absent a factual foundation to support a reasonable suspicion that counsel improperly influenced an expert so as to interfere with the expert’s duties of independence and objectivity, a party should not be allowed to demand production of draft reports or notes of interactions between counsel and an expert witness. Compelling production of drafts would inhibit careful preparation of the report and discourage parties from engaging experts to provide careful and dispassionate opinions and would instead encourage partisan and unbalanced reports.
The Ontario Court of Appeal’s decision reminds us that expert witnesses are there to help the trier of fact understand complex or technical issues, and the lawyers are an important part of that communication.
With winter in full swing, operating All Terrain Vehicles (ATVs) and snowmobiles for recreation and transportation is very common. In recent years, there has been an increase in the number of registered off-road vehicles…and accidents. ATV and snowmobiles pose certain risks. Similar to motorcycle accidents, ATVs lack structural protection to riders in the event of a crash. As a result, ATV or snowmobile accident victims often sustain very serious injuries, including:
• Traumatic brain injuries
• Spinal cord injuries
• Severe fractures
• Scarring or disfigurement
• Chronic pain
• Wrongful death
Common causes of snowmobile and ATV accidents include:
• Forms of premises liability such as hidden hazards, falls through ice, poorly maintained trails
• Use of drug or alcohol while driving
• Defective repairs on machinery
• Negligent operation and/or reckless driving
ATVs are required to be insured. If you are injured in an accident involving an ATV, your rights are largely governed by the automobile insurance legislation and you should contact a personal injury lawyer right away. Often, these cases involve suing the municipality or region which involve a very short deadline to put them on notice of such a claim.
This can be a very daunting time as you have likely become accustomed to having the care of a number of health professionals in the hospital.
However, it will not be a daunting time with the right lawyer. This is a critical time for you to contact a lawyer so that they can put together the appropriate rehabilitation team for you with your input and from hospital staff. After obtaining a good understanding of your injuries and needs, your lawyer can ensure that your accident benefit policy (if injured as a result of an automobile accident) is effectively used to pay for a range of services and devices such as in home attendant or nursing care, home accessibility modifications and vehicle modifications, chiropractic, psychological, physiotherapy services; medication; rehabilitative equipment; vocational training.
You need a highly qualified Occupational Therapist and/or Case Manager quickly to ensure your rehabilitation is arranged and coordinated and that your home is a safe setting for you to return to. We can help you find one.
Virk Personal Injury Law is conveniently located across from Hamilton General Hospital but we will come to any hospital prior to your discharge to provide you with your free consultation and take all the time needed to explain your rights and ensure everything is in place for your return home.
The Financial Services Commission of Ontario (FSCO) recently announced further changes to the Statutory Accident Benefits Schedule (SABS). The changes will affect service provider regulations, administrative penalties, transportation expenses and interest rates. Service providers, in particular, should familiarize themselves with the changes. The following is a brief summary of the key changes.
Effective December 1, 2014:
Effective January 1, 2015:
A claim for punitive damages is not a claim for disability benefits and can be pursued in a lawsuit separately to punish an insurance company for bad faith conduct. In the recent decision, Fernandes v. Penncorp Life Insurance Company, the Court of Appeal affirmed the Trial Judge’s decision awarding $200,000 in punitive damages, as the Appellant, Penncorp’s conduct met the test for punitive damages as being “highhanded, malicious, arbitrary or highly reprehensible conduct”.
The Respondent, Fernandes, suffered a serious back injury after falling off a scaffold and two days later falling off a trailer. Following the two accidents, he was unable to work as a self-employed bricklayer. He claimed disability benefits from Penncorp who accepted Fernandes as totally disabled and paid him a monthly benefit for approximately seven months. Penncorp subsequently terminated Fernandes’ benefits, contrary to the medical evidence. Penncorp failed to formerly advise Fernandes of the termination of his benefits until about five months after the fact. It simply stopped sending the disability benefit cheques.
Penncorp relied solely on surveillance that showed Fernandes doing some work around the house, which included shovelling, pushing a wheelbarrow, and lifting the wheelbarrow and a wooden skid into the back of a trailer. This surveillance was not inconsistent with Fernandes’ evidence that he did some limited housekeeping activities.
The Court of Appeal upheld the trial judge’s decision awarding $200,000 in punitive damages. The trial judge concluded that the Defendant breached its insurance contract with the Plaintiff to pay disability benefits and its duty of good faith. Having reviewed the evidence, the trial judge concluded that Fernandes continued to suffer from a total disability contained in the insurance policy, i.e. he was unable to perform substantially all of the duties of his occupation and he was disabled from any occupation for which he was reasonably suited for by education, training or experience.
In addition, Penncorp had not dealt with Fernandes in a fair and balanced manner. Instead, Penncorp took an adversarial approach to Fernandes’ claim and terminated his benefits in the face of medical evidence to the contrary and on the basis of surveillance that did not reasonably support the decision to terminate benefits.
The Court of Appeal, however, reduced the damages for aggravated damages (mental distress) from $100,000 to $25,000 as this award was inordinately high and entirely disproportionate and there was evidence that circumstances apart from Penncorp’s conduct contributed to Fernandes’ psychological distress.
Unfortunately, insurance companies frequently unfairly deny payment of disability claims. This case, however, can be used as a powerful tool to ensure insurance companies comply with their duty of good faith. The prospect of high punitive damages awards can affect the way in which insurance companies approach claims.
Distracted driving is much too common. It accounts for four million traffic accidents in North America each year. Although Ontario made it illegal in 2009 to drive while using a handheld device, last year approximately 75-80% of all car accidents resulted from driver inattention.
It is illegal to use a handheld device while driving but that does not seem to be eliminating its use. This is especially alarming given the day and age we are in with heavy reliance on smartphones which only seems to be increasing. One suggestion is that we create a culture stigmatizing driving and texting and speak up when we see people doing it, especially where you are a passenger and have the opportune moment to enforce zero tolerance.
Distractions don’t end at using a handheld device while driving. For example, a very high number of car accidents occur each year outside of Canada’s Wonderland on Hwy 400, as many drivers are looking at the rides instead of paying attention to the road. The OPP has been fining people that they catch looking at the rides while sitting in traffic or just driving by. The number of accidents in the area is a testament as to how dangerous distractions are while driving!
Eliminate all distractions while driving and remain focused on the task at hand – arriving safely to your destination.