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Legal decisions changing Bodily Injury claims processes

April 29, 2014   by Granite Global Solutions

Toronto, April 29, 2014:  Adjusters and insurers are urged to be very specific in outlining to the insured person all the reasons why Insurer Examinations are reasonably required, or there may be serious consequences, warns Laurie Walker of Granite Claims Solutions and Jason Frost of Hughes Amys LLP.

Speaking at a symposium for the legal profession hosted by MDAC (Multi Disciplinary Assessment Centre),  they used as an example the recently released Financial Services Commission of Ontario decision –  Augustin v. Unifund (FSCO A12-000452, November 13, 2013) where the arbitrator provided penalties against the insurer as a result of a lack of reasons to substantiate the insurer’s position. 

Walker also provided sample wordings to indicate appropriate reasons to assist the insurer participants.

“This is just one of the issues that is currently being clarified by case law,” said Frost as he introduced a number of cases that are setting precedents in the application of Bodily Injury and MIG cases. “The insurance industry needs to improve its training and processes in handling these claims so that they conform to the legal developments”.

About MDAC:

For more than two decades the Multi Disciplinary Assessment Centre (MDAC) team have performed thousands of individual and multi-disciplinary Medico-Legal Assessments, using the complex procedures involved in assessing physical and psychological disability. MDAC has formalized its quality management system, and is ISO registered.  MDAC uses health care professionals who are experienced and knowledgeable regarding Expert Witness Rule 53, current regulations and case law that affect the delivery of services. MDAC only utilizes the highest quality professionals including Certified Life Care Planners and Certified Vocational Evaluators. MDAC is part of Granite Health Solutions.   www.mdacentre.com

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