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.
Priority Disputes
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?
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 do not conduct business in Ontario. Unfortunately,...
Ontario 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 in your insured’s vehicle at the time of the...
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 pecking order is found in subsections 268 (2) to (5.2)...
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 my client had priority over this claim because he...
Priority Disputes 101: The Claimant
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....
Priority Disputes 101: Private Arbitration and The Final Frontier
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...