Ontario Insurance Coverage 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.
Can Occupiers Deduct SABS? Court of Appeal’s Decision in Diep
The Ontario Court of Appeal’s decision in Diep v. Mac’s Convenience Stores examines whether occupiers and contractors can deduct SABS under section 267.8 of the Insurance Act and defeat OHIP’s subrogated claim.
Medical and Other Reasons” Under the SABS After Varriano: Part 2
Accident benefits notices are facing increasing scrutiny at the LAT, particularly where insurers rely on generic wording or unsupported conclusions. This blog examines how recent decisions, including Varriano, are reshaping the analysis of “medical and other reasons” under the SABS and what adjusters can do to draft more defensible denial notices. It discusses practical drafting strategies, common pitfalls, substantial compliance, and why file-specific reasoning matters more than mechanical wording or templates.
Medical and Other Reasons” Under the SABS After Varriano: Part 1
Learn how Varriano changed SABS notice requirements and when insurers must provide medical and other reasons for accident benefits determinations.
No Crash, No Cash: Divisional Court Denies Bus Injury Benefits
Is a public transit rider entitled to accident benefits for injuries inside the vehicle? The Divisional Court confirms not unless the vehicle collided with “another automobile or any other object”. This decision...
LAT: Is a Mobility Scooter an “Automobile” in Ordinary Parlance?
Mobility scooter or automobile? The Ontario LAT in Bartok v Intact says “automobile” under the ordinary parlance test. A critical look at the decision and its implications for accident benefits and insurance.
When Minor Isn’t Minor: Why Context Matters in MIG Classification
The Divisional Court in Marcelo clarifies that MIG classification is injury-based, not impairment-based. Context is critical in accident benefits files.
The Nexus Test in Ontario Accident Benefits: Wilson and Wais
Two Coachman decisions appear to point in opposite directions on nexus and priority. They don’t. Wilson and Wais reveal a disciplined framework reshaping how accident benefits claims are adjudicated at the LAT.
SABS Accident Found, But Late Notice Bars Claim: Jones
The LAT found a slip and fall near a vehicle was an accident under the SABS, but late notice accident benefits deadlines and missed reporting barred the claim.
Loss Transfer Fault in Ontario: Why Fault Matters & How it Works
Loss transfer disputes don’t fail because fault is complicated — they fail because it’s misunderstood. This post explains why fault matters, where it came from, and why tort findings are irrelevant.
Why Ontario Insurers Must Keep Log Notes: A Practical Perspective
Why log notes are effectively mandatory for Ontario insurers. FSRA, UDAP, LAT practice, and industry standards all make contemporaneous notes indispensable.
Ontario Court: All Drivers Have a Duty to Avoid Accidents
Ontario’s Superior Court confirms all drivers share a duty to avoid accidents — even by taking steps to prevent harm. Learn what McFee v. Sutram means.
OPCF 47R Explained: Ontario SABS Changes and the 2026 Reforms
Ontario’s new OPCF 47R endorsement fixes accident benefit priority issues and prepares insurers, agents, brokers, and policyholders for Ontario’s 2026 SABS reforms.