Canadian Underwriter

accident benefits

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News AdjustersClaimsInsuranceLegalLegislation / Regulation

Aviva wins appeal regarding EI deductions from IRB benefits

September 6, 2022 by David Gambrill

Aviva Canada successfully appealed a tribunal decision that called for the insurer to pay full auto insurance income replacement benefits (IRB), with no deduction, on top of the sickness benefits she was already receiving under the Employment Insurance Act (EIA).

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Auto insurers had it right in accident benefits HST case, Appeal Court rules

August 3, 2022 by David Gambrill

Auto insurers that paid catastrophically impaired accident victims attendant care benefits prior to a regulatory clarification in 2019 do not have to pay provincial sales tax above and beyond the benefit limits outlined in law, the Court of Appeal for

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News ClaimsInsuranceLegal

Should you attach a dispute-resolution form to a denial letter?

June 8, 2022 by David Gambrill

An injured auto driver has lost an appeal against her insurer, which denied benefits a full seven years before she launched her legal challenge against the decision. One notable aspect of the case was whether the claimant received a dispute

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News AdjustersClaimsInsuranceLegal

What auto insurers need to deny coverage based on alleged suicide attempt

May 11, 2022 by David Gambrill

Editor’s Note: This article has been corrected so that all incorrect references to Unica have been replaced with correct references to Optium. Canadian Underwriter apologizes for the error.   If an insurer wishes to deny auto coverage to an injured

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News InsuranceLegislation / Regulation

How Ontario plans to reform auto insurance

April 29, 2022 by David Gambrill

Ontario’s 2022 budget has a short paragraph dedicated to “reducing the cost of auto insurance,” including creating more choice for consumers, cracking down on auto insurance fraud and “enhancing fairness,” which would include new guidance on territorial rating. Exactly how

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News ClaimsInsuranceLegalLegislation / Regulation

How to lie to your auto insurer and not repay your benefits

April 11, 2022 by David Gambrill

A claimant who lied to TD Insurance about an acquaintance being present with her in a car crash so that her acquaintance could collect accident benefits does not have to repay her own benefits because of the misrepresentation, Ontario’s License

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News CatastrophesClaimsInsuranceLegal

A CEO is injured while jogging. Does his personal or commercial auto benefits apply?

March 8, 2022 by David Gambrill

A company CEO who has both personal and commercial auto insurance is not considered to be a “deemed insured” under the commercial auto policy if he has never before driven a company vehicle – even if he had access to

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News ClaimsInsuranceLegal

Court upholds minor injury guideline on shoulder tears

March 7, 2022 by David Gambrill

Partial shoulder tears are “minor injuries” under Ontario’s Minor Injury Guidelines (MIG), which cap accident benefits for drivers suffering minor injuries at $3,500, the License Appeal Tribunal (LAT) has confirmed. Mohd’Ismail Patel, a delivery truck driver, was injured in an

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News ClaimsClaims CanadaInsuranceLegalLegislation / Regulation

You must show more than pain to claim a non-earner benefit

February 23, 2022 by David Gambrill

It’s a long-held proposition that auto insurance is supposed to restore an injured driver to their pre-accident state of health — but what if that state was one of chronic pain following 15 years of being injured in a prior

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News Insurance

Court weighs in on when insurers are prejudiced in AB claims

February 8, 2022 by David Gambrill

In considering whether an insurer is prejudiced by extending the two-year limit to file an appeal of termination of accident benefits, an appeals tribunal should be considering the period of the proposed extension, not the sum total of the time

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News InsuranceLegalLegislation / Regulation

Canada’s top court weighs in on HST case concerning accident benefits

January 24, 2022 by David Gambrill

Claimants who sought a settlement with insurers over HST being deducted from their accident benefits have lost their bid to have their claims certified as class actions. The Supreme Court of Canada rejected leave to appeal the case on Jan.

News ClaimsClaims CanadaInsuranceLegal

Ontario auto claimants seek leave to appeal HST dispute to Supreme Court

October 13, 2021 by Greg Meckbach

A dispute over the handling of sales tax in Ontario auto accident benefits claims could reach the Supreme Court of Canada. In 2018, several auto clients filed lawsuits in Ontario against accident benefits insurers. Plaintiffs allege those carriers either included