It is important for social workers and health care providers to understand what benefits are automatically available to those injured in a motor vehicle accident. We regularly publish recent legal findings related to accident benefits here. You can also Subscribe to our Electronic Newsletter to be kept informed on this topic.
Read the Superintendent’s Report on the Definition of Catastrophic Impairment in the Statutory Accident Benefits Schedule
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| Release Date |
Title |
| May 17, 2013 |
| Insurer cannot deduct ODSP payments from non-earner benefits |
| Anglin and State Farm – NON-EARNER BENEFIT; deductibility of Ontario Disability Support Program payments; provision of Ontario Disability Support Program Act requires inclusion of non-earner benefits in income; the Ministry subtracts the amount of NEB payments from the ODSP benefit; insured signed an Agreement to Reimburse and Direction which permitted the Ministry to be reimbursed from money considered income. |
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| Mar 24, 2013 |
| Special award made where insurer's conduct to deny income payments unreasonable. |
| Federico and State Farm – SPECIAL AWARD; punish insurers that unreasonably fail to pay accident benefits; award proportionate to insurer’s blameworthiness, vulnerability of insured, harm to insured, deterrence, advantage gained by insurer, and consider any other penalties that might be imposed on insurer due to misconduct; insurer found to have unreasonably withheld payment of income benefits; special award set at 20% of withheld payments. |
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| Mar 10, 2013 |
| Off road bike operator entitled to accident benefits from Fund |
| Motor Vehicle Accident Claims Fund and Therrien – IS AN OFF-ROAD DIRT BIKE AN “AUTOMOBILE”; dirt bike operated off-road on private track not owned by operator; insurance required under the Off-Roads Vehicle Act; motorcycle was an “automobile” under the SABs; does the Off-Roads Vehicle Act include Statutory Accident Benefits; Fund took position that bike not required to be registered under HTA and therefore not Fund’s responsibility for accident benefits; argument seen as red herring |
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| Mar 03, 2013 |
| Long term disability benefits not deductible from IRB payments |
| Bennett and Motor Vehicle Accident Claim Fund – DEDUCTIBLITY OF LTD BENEFITS FROM IRB PAYMENTS; insured settled a long term disability claim receiving a lump sum; characterization of settlement; payment to settle a legal obligation arising from commencement of litigation versus payment under an income continuation benefit plan; no breakdown of the lump sum settlement with the LTD insurer provided; LTD settlement was not deductible. |
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| Feb 09, 2013 |
| Insured evidence not credible and denied further medical treatment. |
| Ng and Intact – Access to further medical treatment; insured unable to identify impairments with clarity; difficult to determine reasonableness of proposed treatment; insured’s evidence crucial in deciding whether medical expenses and related assessment expenses were reasonable and necessary; insured provided evasive answers and had limited recall; insurer had spent upwards $100,000.00 for assessments and medical treatment for insured and mother; the insured had little recall of the treatment provided; little credible evidence to suggest treatment claims at arbitration had any validity. |
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| Jan 20, 2013 |
| Slip and fall injury not related to use of car. |
| Nickerson and Security National – WHAT IS AN ACCIDENT; insured slipped in parking lot as she was walking to parked car to retrieve broken windshield wiper; insured had previously walked into store from parking lot without incident; injuries not directly caused by use or operation of vehicle; injury due to slip and fall on ice; any connection between the use or operation of the car and the injury was remote; two part test – did the incident arise from ordinary and well known use and operation of a car and did the use or operation of the car directly cause the injury; not enough to show that car was involved in some peripheral or incidental way. |
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Disclaimer: This blog is not intended to provide specific legal advice. This information should never replace the advice of a lawyer familiar with the specific facts relating to your particular situation. Reviewing our website should not be viewed as having sought professional advice.
You may also be interested in viewing these recent presentations given by Robert Deutschmann:
- FSCO 5 Year Review - Strategies for Health Care Providers
- The Power of Advocacy
- Lawyer, Case Manager, Candlestick Maker
Here are further presentations given by Doug O'Toole:
- Capacity to Manage Finances and Strategies when Capacity is Impaired
- The Law of Mental Capacity
Further Resources
FSCO Expert Panel – Proposed CAT Changes
Recommendations for Changes to the Definition of Catastrophic Impairment
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