The claimant was employed at the time of MVA and received Workers Safety Insurance Benefits (“WSIB”). And, subsequently, the claimant elected to opt out of the WSIB benefits and instead elected to pursue (a) a lawsuit (“tort action”) against the unidentified driver. Under s.61 of the SABS, if a claimant makes an election under the … Read More
<Preliminary Issue Decision in the Tribunal Hearing> -There was a following preliminary issue decision in the Tribunal hearing earlier today:. – Was the Aviva Insurance Company’s Notice of Denial to pay accident benefits containing straightforward and clear language enough to trigger a 2-year limitation under the SABS? – The answer was “No.” The adjudicator was … Read More
Calculation of Income Replacement Benefits for claimant involved in a motor vehicle accident in August 2020 What is required? 1. Client’s filed income taxes for 2019 and 2020 2. Calculation of IRBs under s. 7(2) of the SABS 3. Post-accident bank deposit Under s. 7(2) of the SABS, Income Replacement Benefits were calculated as follows: … Read More
Recently, the Certas Home & Auto Insurance Company requested a new Form 1 for its determining our client’s attendant care benefits under the SABS. The Form 1 was submitted by our occupational therapist recommending a total of $2.5K in assistance. Form-1 included feeding, medication management, and most significantly, 22 hours a day for supervision due … Read More
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
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
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
-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
The claimant was earning the annual income of $150,000.00 during the last fiscal year before the subject motor vehicle accident. $150,000.00 (gross employment income –> a self-employed person may designate his gross employment income from the last fiscal year of the business that ended before the accident as his “gross annual employment income.”) – … Read More
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
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