FAIR – supporting auto accident victims through advocacy and education
FAIR – supporting auto accident victims through advocacy and education
FAIR – supporting auto accident victims through advocacy and education
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It was eight months after my car accident; I was sitting on my bed, staring at the sky blue walls of my bedroom.
I knew nothing else but these three things: I was still suffering with a traumatic brain injury, I was without friends and I desperately and selfishly wanted to die.
Ontario’s Liberal government’s deeply ingrained struggles with honesty and transparency continue to taint their governing legacy.
That struggle is most pronounced in the Liberal’s ongoing war with Ontario’s Independent Officers of the Legislature, who are tasked with holding government and provincial agencies accountable.
http://www.huffingtonpost.ca/m
PALM BEACH, FLA.—Donald Trump said he received a $17 million (US) insurance payment in 2005 for hurricane damage to Mar-a-Lago, his private club in Palm Beach, but there is little evidence of such large-scale damage.
https://www5.fsco.gov.on.ca/AD/5029
Based upon the evidence received concerning the failure by State Farm to provide its O.T. Assessor with even the basic and obvious information required for her to determine that the Applicant had not, in fact, received any of the type of care set out in these treatment plans, it is clear that the two treatment plans subject to this arbitration were not properly denied or assessed. Therefore, I find that these two denials were unreasonable and the withholding of payment for these services was improper under the Schedule. Accordingly, I order a special award in the amount of $5,500.00, inclusive of interest, payable to the date of this order. This award is based upon the simple mathematics suggested by the Applicant’s counsel (and not specifically challenged by State Farm) which in my opinion results in an entirely appropriate calculation and avoids the delay inherent in the more usual approach of leaving the interest calculation to be determined after the fact by the Insurer’s accounting system. []
Similarly, Wawanesa argued that Mrs. Colandrea’s refusal to talk settlement for five months prolonged the proceedings. While Wawanesa acknowledged that Mrs. Colandrea was undergoing medical assessments during those five months to support her removal from the MIG, it argued that Mrs. Colandrea could have asked Wawanesa if it had changed its MIG position during that time. Yet, Wawanesa did not disclose what its MIG position actually was during those five months. Furthermore, neither party provided detail about the medical evidence. For these reasons, I have insufficient evidence to assess the reasonableness of Mrs. Colandrea’s decision to postpone settlement discussion
In addition, Wawanesa argued that Mrs. Colandrea’s “accumulation of expert reports” was “entirely unnecessary” to the proceedings. It argued that the cost of those reports was “grossly disproportionate” to the value of the issues in dispute, but did not include in its valuation of the issues the removal of Mrs. Colandrea from the MIG. Taking her removal from the MIG into consideration, I do not find the cost of the reports to be “grossly disproportionate.”
Lastly, Wawanesa alleged that the Applicant used her medical reports in the tort claim. However, it did not support this allegation with evidence. Furthermore, Wawanesa did not say whether the Applicant was reimbursed for those reports in the other proceeding. In any event, this argument is irrelevant to the question of whether the reports were necessary for these arbitration proceedings. Absent evidence about the relevance of the Applicant’s expert reports to these proceedings, the insurance company’s argument that they were “entirely unnecessary” is unsubstantiated.
It follows that these factors are also neutral in this expense hearing.
(f) whether the insured person refused or failed to submit to an examination as required under section 42 of Ontario Regulation 403/96 (Statutory Accident Benefits Schedule — Accidents on or after November 1, 1996) made under the Act or refused or failed to provide any material required to be provided by subsection 42 (10) of that regulation.
(g) whether the insured person refused or failed to submit to an examination as required under section 44 of Ontario Regulation 34/10 (Statutory Accident Benefits Schedule — Effective September 1, 2010), made under the Act, or refused or failed to provide any material required to be provided under subsection 44 (9) of that regulation.
I will consider factors (f) and (g) together.
While it is undisputed that Mrs. Colandrea refused to attend two insurer’s examinations, the insurer did not explain the relevance of her refusal to this expense hearing.
Wawanesa said that her refusal was “obstructionist,” but did not say how. Mrs. Colandrea stated, at the time that Wawanesa requested her attedance, that she considered the insurer’s examinations to be unwarranted or duplicative, but Wawanesa did not address this fact in its submissions. As a result, I am unable to assess whether the refusal to attend was reasonable.
Furthermore, Wawanesa did not say whether it had expended any resources as a result of Mrs. Colandrea’s failure to attend. The evidence before me does not support such a position. Rather, it suggests the opposite — that Mrs. Colandrea’s failure to attend two insurer’s examinations saved Wawanesa additional expenses in these proceedings.
While it may be the case that a failure to attend creates additional costs for an insurer in mounting a defence at arbitration, that does not appear to be the case here, where the matter settled before a hearing. The insurer did not meet the burden of proving its argument. Consequently, I am not persuaded that the bare fact of the Applicant’s refusal to attend supports an award of expenses to one party over another.
It follows that these criteria are neutral to my assessment
Having considered the seven criteria, I conclude that Mrs. Colandrea is entitled to an award of expenses.
A recent news report highlighted the disastrous consequences for an innocent motorist, following a collision just hours after the Ontario government’s mandated June 1, 2016 automobile insurance cuts.
http://www.torontosun.com/2016
Fairness is still lacking in Ontario’s auto insurance system and a balance needs to be struck between both lower premiums and the right level of benefits, Don Forgeron, president and chief executive officer of Insurance Bureau of Canada (IBC), said during last week’s 96th annual convention of the Insurance Brokers Association of Ontario.
The Ontario government’s fumbling on auto insurance continued this week with news that rates will rise, pushing the government even further away from its self-imposed reduction target of 15 per cent.
All insurance policies have standard coverages and limits and deductibles. Consumers can change or augment them like an à la carte menu. Back in June, Ontario changed the wordings and limits in some of those coverages, and drivers should no longer just assume what’s now on offer is good enough or indeed, in some situations, even close to adequate.
http://driving.ca/auto-news/ne
When a file is transferred from one lawyer to another, one danger is when nothing happens on the file due to a clumsy transfer or missing critical information. A new file that has not been looked at can be a ticking time bomb. Deadlines like limitation periods can pass by unnoticed, and Rule 48 administrative dismissal dates can be discovered too late. The resulting malpractice claim can have lawyers pointing fingers at each other. Consider the following tips whether you’re transferring a file or on the receiving end: the biggest tip is lawyers involved in a transfer should ensure big events like deadlines and dismissal dates are communicated up front.