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Accident Benefits Update: Proving Chronic Pain? – a Cautionary Tale

Campisi Law on November 3, 2020

In S.K. v. Aviva Insurance Canada (2019 CanLII 126203) recent Reconsideration Hearing before the Licence Appeal Tribunal (LAT), the applicant S.K. argued that the LAT had erred in fact and at law by finding that her injuries were appropriately treated under the Minor Injury Guideline (MIG). As a result of this finding, her claims for outstanding treatment plans were also dismissed.

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Accident Benefits Update: Shades of Grey between Moderate and Marked Impairment

Campisi Law on September 3, 2020

K.S. andTD Home and Auto Insurance Company (2019 CanLII 22189), a recent decision by the Licence Appeal Tribunal (LAT), considered the fine line for establishing catastrophic impairment (catastrophic) under s.3(2)(f) of the Statutory Accident Benefits Schedule or SABS (prior to June 2016), which deals with Mental and Behavioural Disorders (MBD). The applicant, K.S., was injured on October 28, 2014 while riding his bicycle. He was struck by a passing motorcyclist and flung from his bike, landing on the pavement and splitting his head open. As a result of the accident, K.S. sustained physical injuries to his head, upper body, knees and a fractured neck. He also suffered psychological impairments including poor concentration, irritability, anxiety, stress and depression, as well as uncontrollable and sometimes violent outbursts.

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Accident Benefits Update: LAT split on “Reasonable and Necessary” CAT assessments

Campisi Law on June 3, 2020

In V.L. vs. Pafco Insurance Company (2019 CanLII 119760), a recent hearing in writing before the Ontario Licence Appeal Tribunal (LAT), the applicant, V.L sought payment from Pafco, her insurer for the costs of her assessments to determine catastrophic impairment (catastrophic). Pafco had approved approximately 2/3 of the requested $25,719.25, denying the remaining $8,884.00 on the grounds that these costs were not reasonable or necessary. Two denied Chiropractic treatment plans were also in dispute.

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Accident Benefits Update: ONCA’s TOMEC Decision on SABS Limitations

Campisi Law on May 3, 2020

On November 8, 2019, the Ontario Court of Appeal released Tomec v Economical Mutual Insurance Company (2019 ONCA 882). The central issue on the appeal was whether the two-year limitation to start a proceeding following a denial of accident benefits was a “hard” limitation or was subject to the principle of discoverability.

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Accident Benefits Update – Catastrophic Assessment Report Slammed by LAT

Campisi Law on March 20, 2020

The Licence Appeal Tribunal (LAT) recently released P.S. vs. Allstate Insurance (2020 CanLII 87980) a catastrophic impairment claim heard immediately before the COVID measures took effect. In this decision, Adjudicator Hines was required to determine whether P.S., the applicant was entitled to enhanced catastrophic benefits under the Statutory Accident Benefits Schedule (SABS).

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Steps to Follow Immediately After a Car Accident – Keep Them in Your Wallet

Campisi Law on March 20, 2020

Car accidents are unexpected and jarring, often leaving the people involved in a state of shock. It can be difficult to keep a level head and know what to do, especially if there have been injuries. Even those of us who work with accident victims regularly have found ourselves shaken, overwhelmed, and forgetful when we have been victims ourselves.

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Accident Benefits Update: LAT Approves Attendant Care Despite Lawyer’s Return to Work

Campisi Law on March 20, 2020

On March 20, 2020, the Licence Appeal Tribunal (LAT) released its decision in J.W. v. Security National Insurance Company (2020 CanLII 30385). The central question in this decision concerned a catastrophically injured (catastrophic) applicant’s entitlement to Attendant Care (AC) benefits, and the quantum of those benefits if found reasonable and necessary. The applicant, J.W. had been seriously injured in a motor vehicle accident on October 20, 2014 while riding a motorized scooter. He sustained a traumatic brain injury (TBI) and multiple orthopedic and other injuries. Security National, his accident benefits insurer, accepted that he was catastrophic.

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Accident Benefits Update: Legal System Is Prejudiced Against Plaintiffs

Campisi Law on March 20, 2020

Many of you do not know that our legal system is prejudiced against plaintiffs who are injured in car accidents. In response to pressure from the Insurance industry, our Insurance Act has built-in relief for defendant insurance companies from paying damages to plaintiffs. Briefly, damages under a certain amount are subject to an automatic deductible which stays in the defendant insurer’s pocket. So, if a jury awards you $70,000 for pain and suffering, you will only receive $40,000. The jury is not told that this happens.

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