<Costs of examination for $20,765.25 including $19,000.00 for catastrophic determination assessments> Issue: “Is the claimant entitled to the costs of examination in the amount of $20,765.25 including $19,000.00 for catastrophic determination assessments, $1000.00 for transportation and $765.25 for interpretation services?” -1. Section 25(1)5 of the SABS stipulates that an insurer shall pay reasonable fees incurred by … Read More
<Denied chronic pain assessment and physiotherapy treatments Re-adjudicated and Overturned by the Insurance Company> 1. Our applicant’s office has met our onus successfully to prove that the two treatment plans for physiotherapy treatments and chronic pain assessment are reasonable and necessary. 2. Clinical notes and records from all treating doctors have been submitted as evidence … Read More
-Section 25(1) of the Schedule says that the insurer shall pay for the reasonable fees charged for preparing an application under s. 45 for a determination of whether the insured person has sustained a catastrophic impairment, including any assessment or examination necessary for that purpose. -We have relied on several past LAT and FSCO cases … Read More
<CAT Assessment Funding> -Section 25(1) of the SABS states reasonable fees charged for preparing an application under s. 45 for a determination of whether the insured person has sustained a catastrophic impairment, including any assessment or examination necessary for that purpose. -The cost of CAT assessments do not come under the limits of s. 18 … Read More
The opposing counsel of Jevco Insurance wanted the videoconference hearing, but our Legal Services convinced our MVA client not to proceed with this route as more legal expenses should be incurred and that there is no more merits in her case. We are looking into settlement.
16-002858 v State Farm Insurance Company, 2017 CanLII 85692 C.A. vs. Intact Insurance Company, 2018 ONLAT 18-000579/AABS Each constituent assessment that makes up the multidisciplinary catastrophic impairment determination assessment must be reasonable and necessary. The correct test for entitlement to a catastrophic impairment determination assessment is reasonable and necessary. The onus is on the claimant … Read More
<Why do you need to understand the policy of your disability benefits insurance companies?> -While your disability benefits insurance companies are to pay your short-term and long-term disability benefits until you cease to be disabled, your policy contains the definition of disability and duration of your benefits. -Here are examples of how the policy of … Read More
-The plaintiff, who was diagnosed as suffering from Chronic Fatigue Syndrome (“CFS”), brought an action against the insurer he was entitled to long-term disability benefits under the disability insurance policy issued by the defendant, and for punitive and aggravated damages. -The defendant did not dispute the diagnosis of CFS but took the position that the … Read More
<THE LAW OF COSTS IN THE SMALL CLAIMS COURT> -S.29 of the Courts of Justice Act, R.S.O. 1990, c. 43 governs rules on costs in theSmall Claims Court, which reads at section 29: An award of costs in the Small Claims Court, other than disbursements, shall not exceed 15 per cent of the amount claimed … Read More
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