S.C.W.H. was driving when she was involved in a car accident on June 4, 2014. She applied for and received benefits under the SABs. She now seeks payment for medical benefits including chiropractic and physiotherapy services, which Dominion as S.C.W.H. suffered injuries that fall within the MIG. Dominion takes the position as S.C.W.H.’s injuries are minor, her treatment is subject to a $3,500.00 cap within the provisions of the Minor Injury Guideline, and that it has paid this amount.
Latest News Articles
FAIR does not accept responsibility for comments, opinions, statistical information etc. associated with the links listed below. Any opinions, points of view, etc. are not necessarily shared by FAIR.
For a complete list of recent articles, please go to our 'Media Articles' page under 'In the News'.
We are updating our site and we appreciate your patience.
‘How many times can I lose everything?’: Insurance claim denied after woman’s spouse sets fire to bedroom
Terri-lynn Robison stands in the burned-out shell of her bedroom, still in disbelief that her husband set fire to the bed while she was in the room.
Last year, following a heated argument, she told her husband of 11 years their relationship was over and started packing his clothes.
http://www.cbc.ca/news/canada/
Hashi and Certas Direct 2017-03-27 Decision: Arbitration, Final Decision, FSCO 5198
Dr. Mills and Dr. Seon differed in their respective Addendum Reports with respect to the Brief Battery for Health Improvement 2 (BBHI-2) scores, the Test of Memory Malingering (TOMM) scores, the Applicant’s language difficulties and the overall treatment of the Applicant. Dr. Mills testified he never uses these tests, which test for attributes such as feigning symptoms, malingering and lying. He said that results from such tests are unreliable. They do not take into account the patient’s different cultural background, the suspicion toward a female assessor, and attitudes towards women (all aspects of cultural differences) which could have an important effect on the outcome of those kinds of testing.
As a clinical psychologist he was more interested in the whole picture, which included the fact that the Applicant had come seeking treatment and had endorsed a number of features indicative of serious depression. In his opinion, the Applicant was not feigning his symptoms. He noted that two flags ignored by Dr. Seon were the Applicant’s disclosure at Dr. Seon’s interview that he was taking medication for his pain and had been prescribed anti-depressant medication by his family doctor. These should have alerted her that the Applicant was experiencing real issues of pain and depression, and not feigning symptoms.
[]
In making my overall findings with respect to the Medical Benefits and Costs of Examinations, I must note several things stand out.
The first is the marked contrast between the opinion reports of the Applicant and Insurer. This seems endemic to the Adjudication process under the SABS.
That said, I am giving more weight to the Applicant’s testimony and to his self-reported symptoms to the various assessors and his testimony at the Hearing, over the opinions of Drs. Seon and Chiew that the Applicant was likely feigning his symptoms. This is not in any way to question the skills or expertise of these witnesses; I am not qualified to do that. But I am qualified to weigh and prefer particular evidence over other evidence.
[]
On the psychological side, I prefer the evidence of Dr. Mills given my conclusion that the Applicant was neither malingering nor feigning or exaggerating his symptoms. I accept that Dr. Malik, working under the supervision of Dr. Mills, was providing assistance to the Applicant towards understanding the tests when he required it because of language difficulties. The tests administered through Dr. Malik and interpreted by Dr. Mills supported the Applicant’s symptoms of emotional distress and pain which he attributed to the accident.
I support Dr. Mills’ conclusion that the serious and recalcitrant nature of the Applicant’s ongoing physical pain and psychological impairment is a direct result of the MVA. I also endorse Dr. Mills’ finding that the MVA materially contributed to the Applicant’s impairment and poses a significant barrier to his function, an observation I was able to make from the Applicant’s demeanour throughout the Hearing when he attended. His impairments should not be characterized as falling within the MIG.
Applicant Shown to Be Very Active and Not Credible – Not awarded IRBs
The applicant was injured in a car accident on February 21, 2015. He applied for and received benefit including IRBs under the SABs, however, TD terminated the applicant’s IRB on April 4, 2016, taking the position that he does not meet the test for entitlement. The applicant disputes that termination.
Ontarians’ lives in turmoil over arbitrarily suspended driver’s licences
Long-haul truck driver Joseph Monighan of Hamilton was sitting in his rig in a weigh-scale station near Niagara Falls when he found out his driver’s licence was under suspension for non-payment of parking tickets he’d never received.
Reduce Communication-Related Claims by Understanding Cognitive Bias
Understanding cognitive biases can help reduce communication-related claims, which are the biggest source of malpractice claims. While many cognitive biases are dealt with by following some common sense principles, others are not as obvious. From anchoring effect to decision fatigue, knowing how your client makes decisions can help you build rapport with your clients, effectively give recommendations, and help ensure you and your client are on the same page.
Long-Term Disability Series: Received A Long-Term Disability Denial Letter? What To Do Next.
They say waiting is the hardest part.
But it is clear from my experience representing individuals who have been denied long-term disability that this is one of the toughest and most nerve-wracking times in a person’s life.
In B.C., public auto insurance and full tort system not just compatible, but essential
On behalf of the Trial Lawyers Association of British Columbia (TLABC), I write in response to a Focus opinion piece by Laurelly Dale titled “Looking beyond B.C. tort system: No fault and privatization possible as costs outpace rate increases” in the March 24, 2017, edition of The Lawyers Weekly.
Fair Benefits Fairly Delivered A Review of the Auto Insurance System in Ontario
Final Report April 11 2017 Fair Benefits, Fairly Delivered – Review of Auto Insurance System in Ontario April 11 2017 by David Marshall