IBC reveals the five most common types of fraud
“When someone makes a false or exaggerated claim, it’s the honest policyholders that pay for it,” said IBC national director of investigative services Bryan Gast in the release.
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Lorraine Complains: As tow truck operators go to war, who can you trust?
We get used to reflexively knowing who to call if things suddenly go awry. Police, fire, ambulance — all the emergency services that fly under our radar until we need them. Tow truck drivers are in there, part and parcel of the aftermath of any crash or breakdown on our roads.
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City of Toronto and Uber facing $7-million lawsuit over fatal crash
According to the 24-page statement of claim filed in Ontario Superior Court on February 24, Hawkes and Traikov are each pursuing $3.5 million in damages plus expenses. The statement accuses the city of negligence, breach of statutory duty and abuse of public office.
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Do police need a search warrant to obtain a vehicle’s event data recorder?
TORONTO – Police flouted a driver’s rights when they retrieved an electronic recording module from a car wreck days after a crash because they failed to get a search warrant or owner permission first, an Ontario judge has ruled.
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IBC questions ICBC’s push for no-fault auto insurance
The
Insurance Bureau of Canada (IBC) has issued a statement that puts into question the Insurance Corporation of British Columbia’s (ICBC) capability to support a no-fault auto insurance system.
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Near-billion-dollar lawsuit claims ICBC illegally paid victims’ accident benefits to province
B.C.’s public insurer and the provincial government are facing a potential class action lawsuit that could see nearly $1 billion returned to ratepayers and accident victims.
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‘Thanks for ripping me off’: B.C. government, ICBC hit with $900M proposed class action lawsuit
A proposed class action lawsuit has been filed in B.C. Supreme court which, if successful, could mean every provincially-insured driver and injured crash victim in British Columbia will be in line for a share of almost $1 billion.
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Ontario set to announce $20-million boost to give greater access to mental-health therapy programs
The province is rolling out a new program – the first of its kind in Canada – designed to deliver free cognitive behaviour therapy (CBT), online, by phone and in person to individuals, families and youth age 10 and up, depending on their need.
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Toronto researchers test new rehabilitation method for paralyzed patients
The field of brain-machine interfaces has taken off in recent years, with Silicon Valley leaders joining the fray. Companies such as
Facebook and Elon Musk’s
Neuralink envision we will one day be able to use this type of technology to control our laptops and smartphones with our thoughts.
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Canadian Taxi Association – Seniors, disabled will be impacted as insurance crisis takes up to 1000 taxis off the road
OTTAWA, March 4, 2020 /CNW/ – Senior citizens and others who rely upon Accessible taxis are at risk of losing this service as Ontario’s taxi industry is facing a crisis in insurance coverage.
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A.K. v Allstate Insurance, 2020 CanLII 14418 (ON LAT), <http://canlii.ca/t/j5f8n
[
2] The applicant was involved in a motor vehicle accident on July 16, 2010. She was the belted driver of a vehicle that struck the median, spun out of control, struck another vehicle and came to a rest after hitting the guardrail. The applicant applied for and received benefits pursuant to the
Schedule. She then applied to the respondent for a determination that her accident-related injuries resulted in an impairment that met the statutory threshold for a catastrophic impairment. The respondent denied her application: in its view, the applicant did not sustain a catastrophic impairment. In response, the applicant filed an application with the Licence Appeal Tribunal – Automobile Accident Benefits Service (the “Tribunal”) to resolve the dispute.
ISSUE IN DISPUTE
[
3] Did the applicant sustain a catastrophic impairment
within the meaning of the
Schedule as a result of the accident?
RESULT
[
4] Based on the totality of the evidence before me, I find that the applicant has sustained a catastrophic impairment within the meaning of the
Schedule as a result of the accident.
[
43] Dr. Chandrasena, psychiatrist, completed a psychiatric insurer’s examination on July 19, 2017 as part of a multidisciplinary approach that also included an Occupational Therapy In-Home Examination, an Orthopaedic Examination and an Executive Summary.
[
56] I also prefer the evidence of Dr. Becker to that of Dr. Chandrasena. Dr. Becker conduced a thorough and comprehensive review and analysis of the applicant’s mental/behaviour disorder, the impact of the mental or behavioural disorder on the applicant’s life and the resulting level of impairment in view of the impact of the mental or behavioural disorder. Dr. Chandrasena’s analysis, on the other hand, was cursory in nature and failed to provide an adequate explanation as to how he reached his conclusion that the applicant suffered a class 2 “Mild” impairment in the Adaptation domain as set out in the
Guides. I acknowledge that it is possible that the applicant improved in the time between Dr. Becker’s evaluation and that of Dr. Chandrasena’s. However, I find that Dr. Chandrasena did not provide convincing evidence of this.
[
57] Dr. Chandrasena’s draft report dated July 30, 2017 also raises some concerns about his ultimate finding that the applicant sustained a class 2 “Mild” impairment in the Adaptation domain as set out in the
Guides. Dr. Chandrasena, in his draft report, indicates that the applicant suffered a class 3 “Moderate” and class 4 “Marked” impairment in the Adaptation domain. Even though those impairment levels were circled by Dr. Chandrasena in his draft report, he testified that he cannot find any evidence to suggest that the applicant is markedly impaired. He continued to explain that he circled the moderate and marked impairment levels in his draft report as part of a training exercise for the upcoming changes in the legislation. Dr. Chandrasena also went on to explain that the evidence suggests that the applicant has been able to adapt to her circumstances. I do not share this opinion and find Dr. Chandrasena’s explanation regarding his draft report to be troubling.
[
58] Again, the applicant’s mental or behavioural disorders undermine her ability to cope and adjust, leading to an increased perception of pain and increased functional decompensation, resulting in a more pronounced level of disability. I find that the applicant’s functioning in the area of adaptation has been significantly impeded and that she has been unable to return to the independence she enjoyed before the accident, making it difficult for her to maintain her activities of daily living, continuing social relationships, and completing tasks. Dr. Chandrasena’s opinion does not persuade me to discount this finding.
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[1] The Appellant Insurer appeals from a decision of the Licence Appeal Tribunal (the “Tribunal”) ordering the Appellant to pay for medical expenses of the Respondent (also referred to as the “Insured”) pursuant to ss.14-15 of the Statutory Accident Benefits Schedule (“SABS”).
[2] Section 11(6) of the Licence Appeal Tribunal Act provides that appeals from the Tribunal may be made to the Divisional Court, but on a question of law only.
[3] Applying Canada (Minister of Citizenship and Immigration) v. Vavilov, 2019 SCC 65, the standard of review to be applied on this appeal, provided there is a question of law, is correctness.
[7] In our view, reading para. 46 as a whole, s. 3(8) is being used by the Tribunal as an alternate basis for ordering the Insurer to pay the expenses in question. The primary basis for making the order was the Tribunal’s view that the expenses had actually been incurred by the Insured within the meaning of s. 3(7) of SABS. This is clear from the first sentence of para. 46, which reads. “While I am mindful that it is the [Insured’s] onus to prove her case, I am not persuaded by the [Insurer’s] suggestion that the Treatment Plan has not been incurred.” In other words, the Tribunal was of the view that the expenses in question had been incurred. Furthermore, there was an evidentiary basis for him to make this finding, including the accounts from the Treatment Provider detailing the services it had provided (which included the disputed services) and the evidence of the Insured that she had had the treatments in question and owed money to the Treatment Provider for those expenses. We also pause to note that to the extent that there may be a dispute about whether an expense was actually “incurred” within the meaning of s. 3(7) of SABS, that is a question of fact, not a question of law.
[8] For these reasons the appeal is dismissed.
