The case called F. V. v Wawanesa Mutual Insurance Company decided by the Licence Appeal Tribunal (LAT) on January 30, 2017 answers the question on whether or not family holiday expenses can be classified as payable rehabilitation benefit under section 16 of the Statutory Accident Benefits Schedule (SABS).
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On September 27, 2012, the Ontario Court of Appeal released its landmark decision in Pastore v Aviva. Mrs. Pastore was successfully represented by Joseph Campisi, the founding partner of Campisi Law. It was a long and challenging fight over several years and multiple appeals. The stakes were very high for the insurance industry, and Aviva did not want to lose.
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Since the introduction of the “no fault” accident benefits system in Ontario, the legislature has imposed further disclosure obligations on accident victims seeking entitlement to benefits. For example, the Automobile Insurance Rate Stability Act, 1996, (at s.33(1) of the current Statutory Accident Benefits Schedule or SABS) required a claimant to provide to an insurer any information “reasonably required” to assist in determining the claimant’s entitlement to benefits and, if requested, to furnish a statutory declaration. Later, Ontario Regulation 281/03 (at s.33(2)) gave an insurer the right to request a mandatory Examination Under Oath (EUO) from the claimant to gather information pertaining to the application for benefits.
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In Gilbraith v. Intact Insurance Company (2019 ONSC 1875), Intact brought a Summary Judgment Motion to dismiss Ms. Gilbraith’s claim. She had been seriously injured following an unusual chain of events that she claimed was an “accident” as defined in the Insurance Act. On April 11, 2014 she and a friend were walking when she was struck in the eye by an egg, thrown from a passing carwhich fled the scene. As a result, Ms. Gilbraith lost central vision in her right eye.
In Applicant and Royal and Sun Alliance, a recent decision of the Licence Appeal Tribunal (LAT), the applicant was injured in a car accident on March 3, 2014 while she was still a minor (age 14). She applied for accident benefits including non-earner benefits (NEBs) under the Statutory Accident Benefits Schedule (SABS). Her insurance company, Royal and Sun Alliance (RSA) denied the NEBs and treated her injuries under the Minor Injury Guideline (MIG), which caps treatment at $3,500.
Every year, over half a million Canadians sustain a traumatic brain injury. Motor vehicle accidents account for more than 50% of all acquired brain injuries, this according to the Brain Injury Society of Toronto.
Let us begin this post with the sincere hope that you and your family are staying well during this unusual time.
Malitskiy v. Unica Insurance Inc. (18-010164/AABS) a Licence Appeal Tribunal (LAT) decision released January 2, 2020, involved a dispute over entitlement to attendant care benefits and home modifications by the catastrophically impaired (catastrophic) applicant, Sergey Malitskiy.
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If you have been injured in an accident or through an intentional act or negligence of the state, employee or another person, you may ask for damages or monetary awards.
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