Judge Critiques Exclusion Clause in Homeowner Policy
A recent Ontario Superior Court decision may prompt legislative changes with respect to intentional damage exclusion clauses in homeowner policies in Ontario. In Soczek v. Allstate Insurance Co., 2017 ONSC 2262, Morgan J. addressed whether a standard form exclusionary clause...
The Sufficiency of Reasons (Or Not)
A recent FSCO appeal decision from Director’s Delegate Rogers in State Farm and Asamoah (Appeal P16-00067, March 21, 2017) sheds some light on the requirement of adjudicators to provide sufficient reasons when determining entitlement and quantum of benefits under the Statutory...
The Future of Virtual Claims
LexisNexis Risk Solutions has released a study on “The Future of Claims: Touchless Claims Study”. A “touchless” claim is defined in the study as a claims handing process that requires no insurance carrier employee intervention at all. The research found...
The Agony of “De Feet”
Sufficient Medical Reasons the Achilles Heel of the Insured’s Claim (Franic-Temple v. State Farm Mutual Automobile Insurance Company, FSCO A15-006435, March 15, 2017.) When a taxicab ran over Ms. Franic-Temple’s feet and ankles, it was undisputed the medical imaging disclosed...
When is an LTD Claim Not an Insurance Claim? When it’s a Labour Dispute
Overview The Ontario Court of Appeal recently confirmed that a dispute about the termination of long-term disability (“LTD”) benefits could not proceed by way of an action. The plaintiff’s employment was subject to a Collective Agreement between the plaintiff’s employer and...
Ghost Writing in Medical Reports: Something to be Scared Of?
In the case of Kushnir v Macari, the defendant sought an order for defence medicals with an orthopedic surgeon and a neuropsychologist. The plaintiff sought terms to ensure that the reports were not “ghost written”. The court noted that there...
New Driverless Car Bill Introduced in U.K.
A new Vehicle Technology and Aviation Bill has been introduced in the U.K. to address some of the challenges arising with use of autonomous vehicles and which traditional insurance policies cannot respond to. The Bill provides comprehensive insurance coverage to...
Non-compliance with a Tribunal Order may cost you.
The License Appeal Tribunal (the LAT) has found that an insurer’s failure to comply with a production Order from the Tribunal is unreasonable conduct and must be deterred. In B.F. v. Wawanesa Mutual Insurance Company, 2017 CanLII 9821 (ON LAT),...
Dog Walkers – Beware!
In the January 2017 Ontario Court of Appeal decision of Wilk v. Arbour, the Court was asked to determine when a person is considered to be in possession of a dog for the purposes of the Dog Owners’ Liability Act,...
LAT is not the only option for CAT disputes after April 1, 2016
Director’s Delegate Evans has decided that issues can be added to an existing FSCO arbitration after April 1, 2016 instead of commencing an application at the LAT, when the issues to be added “necessarily arise from the issues already in...
