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Accident Benefits Updates: Egg Incident

Campisi Law on March 20, 2020

In Gilbraith v. Intact Insurance Company (2019 ONSC 1875), Intact brought a Summary Judgment Motion to dismiss Ms. Gilbraith’s claim.  She had been seriously injured following an unusual chain of events that she claimed was an “accident” as defined in the Insurance Act.  On April 11, 2014 she and a friend were walking when she was struck in the eye by an egg, thrown from a passing carwhich fled the scene.  As a result, Ms. Gilbraith lost central vision in her right eye.

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ACCIDENT BENEFITS UPDATE: Glass half full?

Campisi Law on March 20, 2020

In Applicant and Royal and Sun Alliance, a recent decision of the Licence Appeal Tribunal (LAT), the applicant was injured in a car accident on March 3, 2014 while she was still a minor (age 14). She applied for accident benefits including non-earner benefits (NEBs) under the Statutory Accident Benefits Schedule (SABS). Her insurance company, Royal and Sun Alliance (RSA) denied the NEBs and treated her injuries under the Minor Injury Guideline (MIG), which caps treatment at $3,500.

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2021 Threshold and Deductible Amounts Released

Campisi Law on March 20, 2020

Recently, the Financial Services Regulatory Authority of Ontario (FSRA) published its 2021 Automobile Insurance Indexation Amounts Guidance. This Guidance, effective January 1, 2021, establishes the amounts related to insurance claims that are subject to indexation for 2021. Indexation is tied to the Canadian Consumer Price Index (CPI) and varies year to year.

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Casino Liability – A New Frontier?

Campisi Law on March 20, 2020

The issue of whether Ontario casinos can be found liable for profiting from losses of problem gamblers is undecided at law.  This finding would require the Anns/Kamloops test to be met, such that the circumstances disclose reasonably foreseeable harm and sufficient proximity between the problem gambler and the casino, without the presence of residual policy reasons for negating a duty of care.  In 2016, the Court of Appeal for Ontario overturned a summary judgement decision which struck a claim on grounds that the provincial regulator did not owe a duty of care to problem gamblers.  Discussed below, the decision has had wide implications and may lead to a novel duty of care in this province.

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Accident Benefits Update

Campisi Law on March 20, 2020

In A.M. v the Dominion of Canada General Insurance Company, 2019 CanLII58194 (ON LAT), a dispute arose over the A.M, the applicant’s Income Replacement Benefits (IRBs). He was injured on December 21, 2017 when his vehicle was rear-ended. He applied for “no-fault” accident benefits including IRBs under the Statutory Accident Benefits Schedule (SABS) from his auto insurer, Dominion.

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ACCIDENT BENEFITS UPDATE: INSURER CAN’T RELY ON PRIOR MIG REPORT

Campisi Law on March 20, 2020

In Applicant v. Aviva Insurance Canada (2018 CanLII 110921), a recent Licence Appeal Tribunal (LAT) decision, the applicant was struck by another car while making a left hand turn on June 30, 2016.  Within two days of the accident, he reported back and left leg pain and began receiving physiotherapy. His employer provided accommodation for his injuries that allowed him to continue working.  He received accident benefits coverage from his insurer, Aviva subject to the $3500 cap under the Minor Injury Guideline (MIG). Subsequent treatment plans for physiotherapy, chiropractic and massage were denied and the applicant commenced a LAT proceeding to challenge the MIG designation and seek payment of the disputed plans.

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