Split ONCA Rules IE Expenses Not Recoverable in Loss Transfer
In a 2-1 split, the Court of Appeal for Ontario has held that the provincial loss transfer scheme does not allow a first party insurer to recover from the second party insurer any insurer examination expenses relating to accident benefits....
Court of Appeal Rules for Insurer in Topsy-Turvy FSCO Dispute
The Court of Appeal for Ontario has set aside a Divisional Court decision from a weird FSCO ruling dealing with multiplicity of proceedings and limitation issues. The facts in Gordyukova v. Certas Direct are somewhat extraordinary, which might explain the differences of...
Not All Insurer Medical Exams Are Consented Equal
Insurer medical examinations and assessments are a vital tool in accident benefits adjusting and in the defence of any personal injury law suit. Given the purpose for these assessments, a unique doctor-patient relationship arises, which can create difficulty when it...
FSCO App. Reverses Controversial Slip & Fall Case
FSCO Director’s Delegate Lawrence Blackman has restored some sanity to the ongoing saga of whether a “slip and fall” incident is an “auto accident”. In Webb v. Wawanesa, Arbitrator Joyce Miller held that the claimant who slipped on some ice...
FSCO App. Upholds Failed Mediation Decision; Stumps FSCO
Director’s Delegate Evans has upheld the February 10, 2012 decision of Arbitrator Rogers in State Farm vs. Leone which found that a mediation was deemed to have failed because it did not take place within 60 days of an application being...
Earner Qualifies for Non-Earner Benefits
The Ontario Court of Appeal has held that a person employed (and earning) at the time of an accident could still be entitled to receive non-earner benefits under the SABS. In Galdamez v. Allstate, the claimant was injured on October 26, 2002...
Surveillance, Choice of Expert Bury Plaintiff’s Threshold Hopes
A Superior Court judge has ruled that a tort plaintiff with alleged chronic pain syndrome failed to meet the statutory threshold of “permanent, serious impairment” arising from a motor vehicle accident. In Dahrouj v. Aduvala, the 48-year-old plaintiff was injured...
Woman falling before Taxi Ride not in Car “Accident”
A Superior Court judge has ruled against a plaintiff seeking to claim accident benefits from tripping/falling on her way to get into a parked taxi. In Barros v. Shah, the plaintiff was planning to go with her daughter (Maria Oliveira)...
FSCO Appeal Pockets Automobile Claim
FSCO has allowed the insurer’s appeal in a controversial decision about whether a pocket bike was an “automobile”. In Bouchard v. Motors, Cassondra Bouchard had a friend named Kristin Stratton, who owned a couple of pocket bikes (described as gas powered...
Claimant Collects Complete (Attendant) Care Claims
In the Henry and Gore Mutual Insurance Company case, the applicant, Mr. Henry brought an application pursuant to Rule 14.05(d) and (h) to determine a dispute with respect to quantum of attendant care payable to an insured for services rendered...
