Floppy Ear Files
Insurance coverage and private arbitration blawg.
It’s like a legal thriller, but with fewer car (or beagle) chases and more “Did they really mean that in the policy?” Let’s decode the mysteries, strategies, and occasional absurdities of this fascinating (in an insurance sort of way) world.
Pinned – Priority Disputes 101: Help!
It’s a Friday afternoon before a long weekend, of course, and you’ve just received a potential SABS priority dispute. A new Application for Accident Benefits arrives on your desk and the claimant alleges that she was...
Principal Dependency Explained – Without Chasing Your Tail
Who counts as a “dependant” under Ontario’s standard auto insurance policy? The answer can determine whether someone is entitled to death benefits, optional benefits, or even which insurer pays under section 268(2) of the Insurance Act.
Applicant insurers must fetch own handling expenses in priority disputes
Must a respondent insurer in a priority dispute reimburse the applicant insurer for legal fees, adjuster’s fees, administrative costs and disbursements incurred while handling the SABS claim?
Priority Rules Rule: Why Out-of-Province Insurers Can’t Dodge Ontario Claims
Does Ontario’s priority dispute scheme apply to an Ontario licensed insurer who issued a policy in Alberta — when their insured is involved in an accident in Ontario?
BCCA finds Coverage: Weed Exclusion Is Half-Baked
Does a marijuana cultivation exclusion in a homeowner’s policy exclude fire losses to the premises where the plants are growing?
Beware of Dog… Liability: How Ontario Law Redefines Ownership
What does it mean to be an “owner” of a dog under Ontario’s Dog Owners' Liability Act? This case provides a cautionary tale for those who care for animals professionally. Mama always had a way of explaining things so I...
Why Foreign Insurers Must Comply with Ontario’s Priority Dispute Scheme
Sometimes people who are not residents of Ontario decide that they want to visit Ontario. In many cases, these visitors have their own auto insurance policies in their home jurisdiction, and many times their insurers...
Claimant’s assault was not an automobile “accident”
The LAT has issued an accident benefits coverage decision, finding a claimant who was assaulted in his vehicle was not involved in an “accident” under the Statutory Accident Benefits Schedule. Overview of assault and...
Court: Coffee Car Coverage Case Confirmed
The Ontario Divisional Court has allowed an appeal in an accident benefits coverage case, confirming that a claimant who was injured from spilled coffee in a McDonald’s drive-through was involved in an automobile...
Loss Transfer: New Fone Who Dis?
Ontario’s auto insurance system is complex, aiming for fairness in compensating accident victims. A key part of this system is the loss transfer scheme. This blog explains the scheme’s purpose, how it works, and its effects on insurers (and policyholders).
Priority Disputes 101: Reflection on Deflection
In our first article in the Priority Disputes Series, I provided an overview of Ontario’s accident benefit priority dispute scheme and the process necessary to pursue and dispute priority. To recap: The priority...
Priority Disputes 101: Notice in 90
Years ago, I had a file where my client received a priority dispute notice. It was for a catastrophic accident benefits claim involving a 26-year-old who had suffered severe brain injuries. There was little doubt that...