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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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Depression and Injury: How to Cope

Campisi Law on March 20, 2020

Frequently, people who have been injured in a collision or other traumatic event will develop depression – especially if the injuries result in chronic pain, brain injury or catastrophic impairment.  Having to face the sudden loss of good health and cope with an injury severe enough to render the person dependent on others for support can result in feelings of inadequacy and helplessness.  Often, there are chemical and hormonal changes in response to injury that produce depression and anxiety.

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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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Changes to Accident Benefits Threaten Both Individuals and the Healthcare System

Campisi Law on March 20, 2020

We have been really rattled over the recent budget for the year 2015-16 by the government with massive changes to auto insurance being tabled that will further restrict access to accident benefits for those injured, and put the medical and rehabilitative needs of Ontarians in jeopardy.  We feel compelled to reach out to others to help us advocate on behalf of those that need these benefits the most.

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Accident Benefits Update: CAT

Campisi Law on March 20, 2020

In E.E. and Aviva Insurance Company, a recent decision of the Licence Appeal Tribunal (LAT), the Applicant, E.E. claimed that he had suffered Catastrophic (CAT) Impairment under the Statutory Accident Benefits Schedule (SABS) following a serious single vehicle collision on January 28, 2012 in which he was a passenger.  His initial complaints included neck and back pain with loss of sensation in his right arm. No neurological defects were noted at the hospital. His condition deteriorated over time, and he required several emergency room visits culminating in significant spinal surgery. He continued to suffer from spasticity in his extremities with severely altered gait and very limited use of his dominant right hand, as well as ongoing psychological impairments.  

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Putting Drivers First? The Government’s Blueprint for Insurance Reform Revealed

Campisi Law on March 20, 2020

Early this year, the government asked for public input into the future of auto insurance in Ontario.  We were cautiously optimistic that they wanted genuine participation from the people most affected by any reforms.  However, now that the “Blueprint” has been published as part of the 2019 Budget, it is clear the Liberals have little interest in putting drivers first.

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