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 claim In Addison v Intact, the claimant had just...
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 “accident”. In Miceli v. TD Insurance, the claimant was...
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).
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 in your insured’s vehicle at the time of the...
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 pecking order is found in subsections 268 (2) to (5.2)...
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 my client had priority over this claim because he...
In SABS Priority Disputes 101: Help!, and SABS Priority Disputes 101: Reflection on Deflection, I discussed that the purpose of Ontario's priority dispute scheme is to ensure an injured claimant receives timely benefits despite any priority disputes between insurers....
This is the last installment in our SABS Priority Disputes 101 series. I encourage you to read the entire series here: SABS Priority Disputes 101: Help! SABS Priority Disputes 101: Reflection on Deflection SABS Priority Disputes 101: Notice in 90 Priority Disputes...
This article was previously posted on March 31, 2020 when the Ontario legislature froze all limitation periods in Ontario. The issue of whether it applied to the 90-day notice requirement in section 3 of OReg 283/95 remains unresolved in a small handful of priority...
This article was previously posted in June 2020 The Ontario Court of Appeal has overturned a lower decision that found an insurer owed a duty to defend an insured in a sexual assault claim, under a commercial general liability policy. The Claim In Southside Muay Thai...