This appeal arose in the context of a dispute between insurers with respect to the payment
of statutory accident benefits («SABS»), and the determination by the arbitrator of a preliminary issue.
The Vice Chair also confirmed that the principle of discoverability does not apply in the scheme
of statutory accident benefits.
The decision in Intact Insurance Company v. Allstate Insurance Company of Canada, 2016 ONCA 609 involved an insurance arbitrator's determination of a priority dispute between two insurers concerning the payment
of statutory accident benefits.
For the statutory scheme to operate properly, counsel must ensure that any settlement
of a statutory accident benefit claim allocates the settlement funds among the heads of collateral benefits applicable in the instant case.
(3) No indemnity is available under subsection (2) in respect of the first $ 2,000
of statutory accident benefits paid in respect of a person described in that subsection.
(4) In case of a dispute in respect of an insured person's entitlement to statutory accident benefits or in respect of the amount
of statutory accident benefits to which an insured person is entitled, interest on the benefits in dispute is calculated at the prejudgment interest rate described in subsection 128 (3) of the Courts of Justice Act that is used for past pecuniary loss, and is payable for the period that begins on the date on which an application to the Licence Appeal Tribunal is brought under subsection 280 (2) of the Act and ends on the date a settlement is reached or a decision is issued that finally disposes of the dispute.
Her current practice focuses on the defence
of statutory accident benefits claims, including acting on behalf of auto insurers in loss transfer and priority disputes between insurers, and tort claims.
(4) If, under subparagraph i or iii of paragraph 1 or subparagraph i or iii of paragraph 2 of subsection (2), a person has recourse against more than one insurer for the payment
of statutory accident benefits, the person, in his or her absolute discretion, may decide the insurer from which he or she will claim the benefits.
(b) are in respect of an insured person's entitlement to statutory accident benefits or in respect of the amount
of statutory accident benefits to which the insured person is entitled.
280 (1) This section applies with respect to the resolution of disputes in respect of an insured person's entitlement to statutory accident benefits or in respect of the amount
of statutory accident benefits to which an insured person is entitled.
(3) An insurer against whom a person has recourse for the payment
of statutory accident benefits is liable to pay the benefits.
25.2 governing the assignment
of statutory accident benefits under Part VI, including the application of sections 279 to 282 to persons to whom the benefits are assigned;
(a) all payments that the person has received or that were or are available for statutory accident benefits and by the present value
of any statutory accident benefits to which the person is entitled;
25.1 governing agreements to settle claims and disputes in respect
of statutory accident benefits under Part VI;
all payments that the person has received or that were or are available for statutory accident benefits and by the present value
of any statutory accident benefits to which the person is entitled;
I still do primarily claims relating to motor vehicle accidents and I do a fair amount
of statutory accident benefits, defending those on behalf of the insurance companies.
Justice Lauwers» holding directly contradicted the practice in place since Desbiens v. Mordini of allowing motor vehicle accident victims to combine physical and psychological ratings to get a Whole Person Impairment (WPI) rating of 55 % or higher to achieve a catastrophic designation under s. 2 (1.1)(f)
of the Statutory Accidents Benefits Schedule (SABS).
Not exact matches
Back in the 1970s and 80s, as a departmental director at the National Highway Traffic Safety Administration (NHTSA) in the USA, the scientist played a major role in channelling the latest findings from
accident research into
statutory regulations governing the inclusion
of active and passive safety technology in vehicles.
Where a workplace
accident has occurred, and the employer has
statutory duties under sections 18 and 19
of the OHSA and simultaneously undertakes an internal investigation, claiming legal privilege over all materials derived as part
of that investigation, an inquiry is properly directed to a referee under Rule 6.45 to determine the dominant purpose for the creation
of each document or bundle
of like documents in order to assess the claims
of legal privilege.
The Plaintiff applied for and received
statutory accident benefits from her insurer, for the total amount
of $ 45,641.00.
There are
statutory time limits to filing a civil claim for damages, and we recommend that you engage the services
of a competent quadriplegia
accident lawyer as soon as is reasonably possible after the
accident.
In this case, the issue was whether the non-pecuniary damages award
of $ 50,000 should be reduced by the
statutory deductible in force at the time
of the
accident ($ 30,000), or the
statutory deductible in force at the time
of judgment ($ 36,540).
(3) A second party insurer under a policy insuring a heavy commercial vehicle is obligated under section 275
of the Act to indemnify a first party insurer unless the person receiving
statutory accident benefits first party insurer is claiming them under a policy insuring a heavy commercial vehicle.
This creates tremendous risk and exposure to the insurer because
of the «open ended» nature
of its
statutory obligation and creates a tremendous incentive to negotiate a «cash out»
of accident benefit claims.
Statutory Accident Benefits, or SABS, which are mandatory for all Ontarians who have car insurance, provide some coverage for family members
of someone killed in a cycling
accident.
i) if the motorised snow vehicle was involved in the incident
of which the responsibility to pay
statutory accident benefits arises, or
The current
statutory accident benefit regime is far too complex and full
of red tape resulting in unnecessary disputes and litigation.
The complexity
of bringing a lawsuit against the government, including the need to comply with
statutory requirements in filing a notice
of claim for injury, make the assistance
of an experienced attorney a valuable asset in any
accident or injury case in which a government entity may be at fault.
In Economical Mutual Insurance v. Caughty, the Ontario Court
of Appeal considered whether a person who tripped over a parked motorcycle was entitled to
statutory accident benefits (SABS).
On appeal, we argued that although the
accident occurred in Delaware, Pennsylvania's
statutory employer immunity applied, and thus, absolved the general contractor
of liability.
The MVACF provides
statutory accident benefits directly to injured persons involved in an automobile
accident or to allow injured persons to recover from owners and drivers
of uninsured vehicles.
Unfortunately, the continued deterioration in the
statutory accident benefits available to car
accident victims and changes to the dispute resolution process, have resulted in a significant erosion in the practical ability
of an
accident victim to pursue benefits which have been wrongfully denied.
For instance, within the context
of a motor vehicle collision, any such contractual term establishing a subrogation claim would be contradicted and overruled by the specific provisions set out in the
Statutory Accident Benefit Schedule and the Insurance Act, which purport that the
accident benefits provider and at - fault driver receive a deduction for LTD benefits paid, not the other way around.
The applicable insurance legislation and
statutory accident benefit regulations, guidelines, bulletins and the regulations surrounding the dispute resolution process under the LAT extend for hundreds
of pages, are often complex and are impacted by hundreds
of decisions by judges and adjudicators.
Accordingly, when snowmobiles are operated on property not occupied by the owner at the time
of an
accident, they are considered «automobiles» for which insurance coverage resulting from an
accident may be available under the individual's own automobile insurance policy, including
statutory accident benefits, third - party liability and underinsured coverage.
It would also include experts retained by a non-party to the litigation (for example,
statutory accident benefits («SABS») insurers), who form opinions based on personal observations or examinations relating to the subject matter
of the litigation for a purpose other than the litigation (referred to in these reasons as «non-party experts»).
Despite any other provision
of this contract, this contract is subject to the
statutory conditions in the Insurance Act respecting contracts
of accident and sickness insurance.
(2) If an insurer in respect
of which a winding - up order has been made under the Winding - up and Restructuring Act (Canada) is liable to pay
statutory accident benefits, the benefits, including any benefits that were outstanding at the time the order was made, shall be paid out
of the Motor Vehicle
Accident Claims Fund.
All payments in respect
of the incident that the plaintiff receives after the trial
of the action for
statutory accident benefits in respect
of pecuniary loss, other than income loss, loss
of earning capacity and expenses for health care.
(2) A lack
of consent does not invalidate such
statutory accident benefits as are set out in the Statutory Accident Benefits
statutory accident benefits as are set out in the
Statutory Accident Benefits
Statutory Accident Benefits Schedule.
(8) Where the
Statutory Accident Benefits Schedule provides that the insurer will pay a particular statutory accident benefit pending resolution of any dispute between the insurer and an insured, the insurer shall pay the benefit until the dispute is
Statutory Accident Benefits Schedule provides that the insurer will pay a particular
statutory accident benefit pending resolution of any dispute between the insurer and an insured, the insurer shall pay the benefit until the dispute is
statutory accident benefit pending resolution
of any dispute between the insurer and an insured, the insurer shall pay the benefit until the dispute is resolved.
288.1 (1) For the purposes
of this Part, the following are listed expenses in connection with
statutory accident benefits:
(1.1) Despite subsection (1) and the
Statutory Accident Benefits Schedule, no statutory accident benefits are payable in respect of an occupant of a public transit vehicle, in respect of an incident that occurs on or after the date this subsection comes into force, if the public transit vehicle did not collide with another automobile or any other object in the
Statutory Accident Benefits Schedule, no
statutory accident benefits are payable in respect of an occupant of a public transit vehicle, in respect of an incident that occurs on or after the date this subsection comes into force, if the public transit vehicle did not collide with another automobile or any other object in the
statutory accident benefits are payable in respect
of an occupant
of a public transit vehicle, in respect
of an incident that occurs on or after the date this subsection comes into force, if the public transit vehicle did not collide with another automobile or any other object in the incident.
268.0.1 (1) The making
of a winding - up order in respect
of an insurer under the Winding - up and Restructuring Act (Canada) shall not be taken into account in determining under section 268 whether the insurer is liable to pay
statutory accident benefits.
(5) Despite subsection (4), if a person is a named insured under a contract evidenced by a motor vehicle liability policy or the person is the spouse or a dependant, as defined in the
Statutory Accident Benefits Schedule, of a named insured, the person shall claim statutory accident benefits against the insurer under tha
Statutory Accident Benefits Schedule,
of a named insured, the person shall claim
statutory accident benefits against the insurer under tha
statutory accident benefits against the insurer under that policy.
Amounts payable for prescribed goods or services that relate to such medical benefits, rehabilitation benefits, attendant care benefits and other
statutory accident benefits as may be prescribed for the purposes
of this section.
288.4 (1) The holder
of a service provider's licence is eligible to be paid directly by an insurer for listed expenses in connection with
statutory accident benefits.
(2) If a person makes a claim for
statutory accident benefits, the person shall furnish the person against whom the claim is made with full particulars
of,
(3) Every contract to which subsection 268 (1) applies shall be deemed to have been amended on the 22nd day
of June, 1990, to include
statutory accident benefits in accordance with the Statutory Accident Benefits
statutory accident benefits in accordance with the
Statutory Accident Benefits
Statutory Accident Benefits Schedule.
if recovery is unavailable under subparagraph i or ii, the occupant has recourse against the insurer
of any other automobile involved in the incident from which the entitlement to
statutory accident benefits arose,