The Tribunal erred in calculating the Attendant Care Benefits quantum.

-RECONSIDERATION DECISION –> R.K. v. Aviva Insurance Canada, 2020 CanLII 94744 (ON LAT) -The incurred hours must be paid accordance with the mandatory Guideline rates and Form 1. Thus, for the reasons above, the Adjudicator granted Aviva’s request for reconsideration. <Overview> Aviva seeks reconsideration of the Licence Appeal Tribunal’s (the “Tribunal”) June29, 2018 Order issued … Read More

Slipped and fell at a gas station? What is the two-part test applied by the court for determining whether this incident is an “accident” under s. 3(1) of the SABS?

S.B. v. Aviva Insurance Company of Canada, 2019 CanLII63363 Chisholm v. Liberty Mutual Group, 2002 CanLII 45020 (ONCA) Greenhalgh v. ING Halifax Insurance Co., 2004 CanLII 21045 (ONCA) The first part of the test, the purpose test, requires a determination of whether the incident resulted from an ordinary and well-known activity to which automobiles are … Read More

Two statutory tests for entitlement to the Income Replacement Benefits

16-000082 v Echelon General Insurance Company, 2016 CanLII 82874 The first test is applicable for the period from one week after the date of the accident until the second anniversary. The claimant is entitled to be paid an IRB if he suffered a substantial inability to perform the essential tasks of his pre-accident employment. After … Read More

Applicant’s both NEBs and IRBs can be advanced to the Tribunal.

16-000063 v Dominion of Canada General Insurance Company, 2016 CanLII 67139 Galdamez v. Allstate Insurance Company of Canada, 2012 ONCA 508 Toresho v. Primmum Insurance Company, 2015 ONSC 516 -Under s.35 (1) of the SABS, the Applicant was entitled to notice from the insurer to elect the benefit she wished to receive. -The Application for … Read More

How do death and funeral benefits work under the SABS?

-Under section 26(1) of the the said Regulation,  an insurance company shall pay a death benefit. -Under s. 27(1) an insurance company shall pay a funeral benefit for the insured who dies as a result of the accident. However, the time limits and monetary restrictions apply. -S. 43(1) states that if a claimant is entitled to a death benefit and a funeral benefit, the insurance … Read More

About FSRA (The Financial Services Regulatory Authority of Ontario)

FSRA was established to replace the Financial Services Commission of Ontario (FSCO) and regulates the following sectors: Property and casualty insurance Life and health insurance Credit unions and caisses populaires Loan and trust companies Mortgage brokers Health services providers (related to auto insurance) Pension plan administrators Financial planners and advisors (proposed) 2. Regulations by the … Read More

The court tossed the action for the denied Long Term Disability Benefits.

Hutton v. The Manufacturers Life Insurance Company, 2019 ONSC 279 – The plaintiff, Ms. Hutton has sued the defendant Manufacturers Life Insurance Company for denial of Long Term Disability Benefits (LTD) under an insurance policy issued by the defendant contracted by the plaintiff’s employer, Quinte Health Care (“QHC”).  However, the plaintiff was bound by the … Read More