How does one apply for Medical-Rehabilitation and Attendant Care Benefits?

Discover the procedure for Med-Rehab and AC applications Although we will consider qualification criteria in more detail in further blog posts, here we will consider the procedure for applying for accident benefits. Medical-rehabilitation (aka med-rehab) benefits The insured must apply for benefits under other policies first (e.g. short-term disability/long-term disability benefits, work insurance, etc.). The form used depends on whether the insured’s injury is catastrophic, non-catastrophic or minor. If the injury is either catastrophic or non-catastrophic, the “Treatment and Assistance Plan” (OCF-18) must be completed and submitted. If the injury is minor, the “Treatment Confirmation Form” (OCF-23) must be. These…

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How is information exchanged in accident benefit claims?

Acquire knowledge of examinations under oath and independent examinations In a claim for accident benefits, both the applicant and the insurer bear rights and obligations. These rights and duties have been balanced in order to make the process fair to each side. Fairness from the applicant’s perspective means getting benefits if they are entitled to them. Fairness from the insurer’s perspective means preventing the applicant from getting benefits if they are not entitled to them. Before examining the parties’ respective rights and obligations, let us first define some key terms. During an examination under oath (or EUO), the insurer’s legal…

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Can I apply for Accident Benefits?

Learn about the legal requirement that must be satisfied in order for someone to be able to apply for accident benefits and some recent cases where it has been applied Accident benefits are intended to facilitate immediate treatment and compensation after an accident. Liability is irrelevant. In most cases, the AB insurer is the injured person’s insurer. Unlike a tort claim, the injury does not have to be permanent and serious. The governing legislation is the Statutory Accident Benefits Schedule (or “SABS”), a regulation under the Insurance Act (or “IA”). In order to apply for accident benefits, one has to…

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What are collateral benefits? If I have any, how will they affect my tort award?

Collateral benefits are explained and it is shown how they can affect your tort and accident benefits claims Collateral benefits include private health benefits or disability insurance or benefits. Depending on the type of benefit, the defendant may be entitled to a setoff or deduction for the amount of the collateral benefit. Collateral Source Benefits Nature Function Deductibility CPP Disability Benefits Federal government program Monthly payments to supplement income for people who are unable to work because of their injury Whether the lawsuit is a tort claim or for accident benefits, the defendant is entitled to a setoff of these…

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What is the connection between a tort claim and accident benefits claim?

Discover the relationship between these two types of lawsuits A MVA file involves two lawsuits, a) the tort claim and b) the accident benefits claim. If a person is injured in a MVA (except on public transit vehicles), they are entitled to certain accident benefits regardless of whether or not they are at fault. There are strict timelines for accident benefits claims. First, it is necessary to claim from the accident benefits insurer before commencing a tort claim against the at-fault driver. Second, it is necessary to notify the accident benefits insurer of the intention to apply for accident benefits…

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Boone v. O’Kelly, 2020 ONSC 6932 – Case Comment

Find out about a recent decision where the defendant’s expert’s evidence was excluded This is a ruling on expert evidence by Beaudoin J of the SCJ. It determines the plaintiff’s motion to exclude the evidence of the defense’s expert witness, Dr. Burns, in its entirety. The defence sought an order dismissing the plaintiff’s motion and that, if Dr. Burns’ evidence is admitted, any concerns about it should go to weight. The ruling is a good opportunity for us to examine how the rules of expert evidence are applied. The plaintiffs include Paul Boone (“Paul”), by his litigation guardian, and his…

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What is an expert report, and when would I need one?

Here you can learn about what an expert report is and when one should be requisitioned The expert report is one of the most important pieces of evidence in a personal injury case. In this post, we will explore more about its nature and function. Expert reports are needed because independent verification of the injury(ies) is required. Some injuries are easier to prove; for example, objective injuries such as a fractured bone can be verified by an X-ray or medical records. Other injuries are harder to prove; for instance, subjective injuries such as chronic headaches are established by expert opinion.…

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A MVA claim – from start to finish

Get a bird’s eye view of the general process of a MVA lawsuit If you suffered injuries in a MVA for which you were not at fault, you can seek compensation from the at-fault driver and, more particularly, his/her insurer. In the consultation, we will review your case. The deductible and threshold are important factors in determining whether a lawsuit is feasible (they are discussed in detail in another blog post). After the consultation, the first major step is to identify whether or not the at-fault driver was insured at the time of the MVA. This fact is usually apparent…

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Alcohol Awareness

After a long winter, sunny days are just around the corner in the month of April. Usually, the weather over the weekends may urge you and your friends to go out for a few drinks to relieve some of the stress you may be facing from your workweek. April is the month for multiple types of awareness. In my previous post, I mentioned that April is the month for stress awareness. However, April is pretty versatile, also holding alcohol awareness! Alcohol is one of the most abused substances in North America. Although not everyone may be abusing alcohol, some may…

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Stress Awareness

Did you know that April is the month for stress awareness? We all face stress or have faced stress at some point in our lives. In a study conducted in 2014, statistics Canada revealed that 23% of Canadians, which translates to approximately 6.7 million people, report stress. These statistics were based on Canadians that are aged 15 years or older. Being residents of Ontario, the study showed that Ontario was held in the higher stress categories. Although stress varies, facing constant stress has a significant impact on high blood pressure to heart disease. We all have different mechanisms when it…

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