Author: Clarke Law - Personal Injury Lawyers Toronto

Ontario’s Auto Insurance Charges

Ontario’s Auto Insurance Charges: The fight for fair premiums, government honesty, and public scrutiny

The Insurance Bureau of Canada has been found to have spurred the government into cutting the coverage of auto insurance, and for nearly the last three years, the Financial Services Commission of Ontario and Ontario’s Ministry of Finance have hidden the records proving it.

My attempts at recovering these records under the Freedom of Information and Protection of Privacy Act were thwarted by the ministry labeling the IBC as a “consultant policy adviser” that demanded confidentiality, before the Information and Privacy Commissioner of Ontario itself. Despite the ministry’s duty of regulating the members of the IBC, they claimed that the IBC’s records—pre-budget consultation submissions as well as lobbying records—should be kept private as they were “policy advice” and not public documents.

Another argument the ministry presented in a sworn affidavit was that since important IBC positions were often the topic of discussion at several Ontario cabinet meetings, then IBC records must be held under the same jurisdiction of cabinet confidence and shouldn’t be released to the public.

Back in May 2016, I appealed against the ministry’s withholding of the records by stating that a dangerous and risky precedent would be set if they included the IBC into the cabinet exemption of confidentiality.

This would set the path for a widespread infringement of the freedom of information legislation, with several meetings and submissions from lobbying groups allowed to become private, had the Financial Services Commission and Finance Ministry had their way.

Thankfully, these unlawful claims were thrown out of court, as per orders PO-3719 and PO-3720 in accordance with last April’s decisions by the Information and Privacy Commissioner.

The records were released the following month, showing that from 2012 to 2014, the Financial Services Commission and the Finance Ministry were often contacted by the IBC in various briefings, meetings, and other forms of communications.

One example of the IBC’s alarming influence can be found from the records of November 2013, where the government was urged to stick to a $3,500 limit for claims of minor injury that the IBC believed could be “vulnerable to disputes”. The IBC sought to make it more difficult for disputes to occur through means of confining medical and mediation claims, preventing them from “being tested, attacked, expanded and dissected by numerous challenges.”

The IBC often sent suggested drafts of legislation and regulations to the government, while simultaneously pressing individual government officials into keeping the IBC in the loop on any upcoming developments. From a record in August 2014, it can be found that the IBC inquired “which recommended reforms contained in IBC’s submission of July 4 have been reviews and are ready for constructive discussions with a view of finalizing proposed regulatory and legislative language.”

Under the guise of “political uncertainty” during the pre-election atmosphere of a cabinet meeting in February 2014, the IBC requested inclusion on the meeting’s agenda that would deliberate the government holding firm to analyzing expensive towing methods, rehabilitation clinic licensing, and integrating improved resolution reform for disputes.

Ontario drivers are now forced to purchase added premiums for superior accident insurance, all because of the basic auto insurance cuts by the government. Despite the chorus of administrations that have promised cheaper premiums, nearly ten million car owners in Ontario must pay steep auto insurance prices while the market is controlled by multiple national insurance companies.

The auto insurance regulation system of Ontario is sorely lacking in transparency and self-sufficiency. Consumers are allowed to openly criticize and object to proposed rates during open hearings in other jurisdictions of North America, such as California, a system that is missing in Ontario. Stakeholders such as the IBC and the data that they surrender must be made public if we are to achieve a system that is truly independent. In other jurisdictions where these can be challenged, the established premiums and set rates are more consumer-friendly than those found in Ontario.

The chokehold caused by these clandestine industry-government partnerships must be put to a stop if we are ever to lead Ontario’s car-owning public out of the low benefits and shrinking coverage brought on by the lack of regulatory transparency when it comes to auto insurance.

Toronto Motor Vehicle Accident Reports

In May, the Toronto Police Service was planning to discontinue the practice of dispatching officers to motor vehicle accidents if no injuries were reported or where vehicle damage did not exceed $2,000.

The Ontario Trial Lawyers Association and the Ontario Safety League, publicly expressed concern that this decision would set a dangerous precedent that could be adopted by other municipal police services across the province.

OTLA collected data on how personal injury lawyers rely on Motor Vehicle Accident Reports (MVAR) from accidents, specifically lawyers rely on the information contained in reports while investigating clients’ case or conducting personal injury civil compensation trial. Surveyed lawyers indicated that 83% rely on the information collected in the MVAR in most cases and 88% of lawyers surveyed responded that the MVAR is very important while investigating their client’s case.

For now, the Toronto Police Service has reversed its decision and will continue to attend the scene of accidents.

A New Rule In Auto Insurance Changes Coverage Based On Timing

On June 1, 2016, a man who was riding his motorcycle on a rural road southwest of Hamilton, Ontario was hit by a car. The man suffered several broken bones, damages to a few internal organs and brain trauma. He was put in a coma for nearly a month as a result. The injuries were so severe that he was pronounced dead at the scene for a moment.
However, his family did not get the $2 million in compensation that they could have gotten had the accident occurred just a few hours earlier on May 31, 2016, Instead the family got a little less than $100,000 in compensation.
The family is struggling to take care of his medical bills. The family cannot get into a proper drug plan because he is not working due to his injuries. The expenses for constant hospital visits have gone up as well as the added costs associated with traveling an hour each way to a hospital in Hamilton. His wife has also been working less because she’s trying to take care of him in his recovery.
The family has lost so much money and has become unable to make a living that they are facing bankruptcy. The worst part about this is that had the injury occurred a day earlier, the family would have qualified to get more compensation so they would not be in this massive financial bind.
The situation has gotten to where the family may not have enough money from the compensation in time for Christmas. The family is even suing the driver that hit the man’s motorcycle. This is to potentially recover additional costs associated with the man’s health care.
What Caused the Compensation Change?
The compensation for the accident was less than it should have been as Ontario insurance laws had changed. While the family knew that the terms on their policy from Intact Insurance were changing, they were not informed of how the process for evaluating injuries changed. This dramatic change in the policy occurred without warning, thus making it harder for the family to get the compensation they needed.
The original compensation rules stated that a catastrophic injury was listed with a Glasgow Coma Scale rating of nine or less. The GCS is used to determine how functional a person is. The man in this story had a rating of three but eventually moved to an eight when he became more responsive.
Had the accident occurred hours earlier, he would have gotten added benefits because he was deemed to have suffered a catastrophic injury. However, the rules changed to where the GCS is no longer used to determine what compensation someone may have. While trauma teams and hospitals still use the GCS when understanding how to take care of a patient, it is not a point of consideration for insurance purposes.
Brain Trauma Patients Suffer
The worst part about this is that brain trauma patients will not be able to get the compensation that they demand for injuries. The fact that the GCS is not fully utilized like it was in the past especially keeps patients from getting all the services and treatments they require. While CT scans and MRIs may still be used, these are often not conducted until weeks or months after an injury.
Outdated Terms
The Financial Services Commission of Ontario, an organization that reviews insurance functions within the province, stated that the terms used to define what injuries are and aren’t catastrophic were outdated. Specifically, those terms were drafted in 1996.
The organization adjusted those terms in accordance with scientific and medical reporting. This includes reporting designed to state how catastrophic injuries are defined and what signs occur with them.
The fact that people were not informed on how catastrophic injury definitions were changed is a serious concern. This shows that the public had been misled over how injuries are to be reported and reviewed.
Reducing Insurance Costs
In addition, the Ministry of Finance adjusted auto insurance rules as a means of keeping insurance from being expensive around Ontario. These rates were changed by altering the requirements associated for covering certain injuries.
However, this is not good enough for many families that are dealing with serious injury problems and the added costs associated with recovering from an injury. The family discussed earlier has struggled to stay afloat financially as a result of those changes.
This is a concern for all drivers in Canada to be aware of. While the cost associated with insurance might go down for some, the coverage points for injuries will decline as well. This is a significant issue that could cause many families to suffer financially if their loved ones experience serious injuries while on the road.

Car Accident Lawyer

Ontario car insurance injury benefits poised to change

Ontario auto-insurance is getting out of hand. Ontarians might as well be heading towards government run insurance. Since most of post-accident health care is already covered by tax payers via OHIP, ODSP, etc. — not auto-insurers — might as well pay directly to the government to insure Ontario drivers. Tax payers are already paying for health care of the injured — it would make sense to get money from the premiums back into the system, not to those fat, inhumane, deplorable, greedy auto-insurance companies.

Personal Injury Jury Awards

Personal Injury Jury Awards

Almost every country in the Western world promotes the concept of equality under the law, where a poor man wearing rags receives the same treatment as a billionaire in an Armani suit. We like to think that our courts operate under the tenet that beneath our physical attributes, the clothes on our backs and the assets in our bank accounts, we are all the same.

But is this always the case?

An Ontario jury recently awarded the plaintiff in a motor vehicle claim the sum of $23,500. The plaintiff had been involved in a rear-ending collision, as a result of which she had sustained serious injuries that will affect her for the rest of her life. Not only did she suffer permanent physical harm, she lost her livelihood. It is not only likely but probable that she will never be able to return to her sales clerk position. With serious physical limitations affecting her day-to-day life, she may not have the capability to train for a different line of work.

For a jury to find that such serious long-term effects were only worth $23,500 is a little mystifying, especially when you consider the $140 million that Hulk Hogan was awarded for the Gawker sex tape incident.

While Hogan undeniably suffered an invasion of privacy and a sizeable dent in his dignity, he was not injured and his livelihood was not taken away from him. His ordeal is most certainly worth something, but is it really worth so much more than a road accident victim whose life has been quantifiably damaged?

One could be forgiven for wondering how much the jury award would have been had Hulk Hogan been the plaintiff. Is society so enamoured by celebrities that the concept of equality under the law gets hazy?

Or is this a symptom of the insurance industry and its lobbyists?

These days, online and print media are rife with stories about insurance fraud. Insurance companies hire entire teams of investigators and go to all kinds of expense in an effort to uncover claims that are exaggerated, embellished or just plain false. We hear about people being denied insurance coverage because they posted the wrong picture on Facebook, or sounded more cheerful than they should have during a telephone conversation.

Society has become conditioned to assume that anyone who is making an insurance claim must be lying. Additionally, most people only expect to see serious motor vehicle accident injuries if there was extensive damage to the vehicles involved. Jurors have a hard time with the idea that someone can get life-changing spinal injuries resulting from what looks like a simple bumper-bashing.

Could it be time to reassess the value of juries to personal injury lawsuits? Jury members are, after all, human beings with human instincts. They do not have the legal training and experience to assess and appropriately weigh evidence, and they don’t always know what the legal precedents affecting their cases are.

Judges have spent years of their lives getting a legal education, reading case law – and in some cases, making case law. Maybe, if we let the judges do the job that they have the training and experience for, we will see a return to the idea of equality under the law.


Ontario Auto Claim Denial Notice May Go to Supreme Court of Canada

Allstate Insurance Company is applying to the Supreme Court of Canada, in the hopes of launching an appeal against a ruling over a benefits denial-notice for an auto-claim.

According to records, Allstate insists the Ontario two-year period of limitation began when notice denying benefits was mailed to the claimant, as opposed to the claimant’s receiving a neurologist’s report (which formed the basis for the benefits denial).

Claimant Edna Klimitz suffered her injury in November 2003, when she was struck by a driver while crossing an intersection. When she applied for her statutory accident benefits two months later (as per Ontario insurance law), she underwent medical examination at Allstate’s request, conducted by orthopaedic surgeon Dr. Edward English and neurologist Dr. Garry Moddel.

On April 15 2004, the claimant received the orthopedic surgeon’s report, and a little over one month later, on May 31, she received Allstate’s notice of benefits-denial. They based their refusal to pay on the grounds that she failed to qualify for the non-earner benefit, drawing attention to the examiners’ reports.

According to the Ontario Statutory Accident Benefits Schedule, five working days after the receipt of an insurer’s examiners’ report, “the insurer shall give a copy of the report and the insurer’s determination with respect to the specified benefit to the insured person and to the health practitioner who completed the disability certificate” (section 37 (5)).

Allstate’s notice of denial was sent with a covering letter, of which Madam Justice Carolyn Horkins of the Ontario Superior Court of Justice wrote in her ruling (released on December 12, 2014): “while this letter stated that Dr. Moddel’s report was enclosed, it is agreed that it was not.”

According to court records, Klimitz did not receive the report written by Dr. Moddel until much later – July 18 2006. She then applied for mediation from the Financial Services Commission of Ontario two days later.

In Ontario law, mediation should begin within two years of the insurer’s refusal to pay out for a claim. In 2012, an FSCO arbitrator ruled that this two-year span actually began when the claimant received the notice of denial, and, as a result, was unable to proceed with arbitration. In March 2013, this ruling was overturned by the FSCO director’s delegate, Mr Lawrence Blackman.

While Allstate applied for a judicial review, Ontario’s divisional court ruled, in 2014, that it was “not unreasonable” for Mr. Blackman “to conclude that the two-year limitation period did not start to run until Ms. Klimitz received a copy of Dr. Moddel’s report” in 2006.

The Court of Appeal upheld the Divisional Court’s decision, ruling that Mr Blackman “was entitled to deference in the interpretation” of Ontario insurance law (a decision released on October 19, 2015). Allstate then applied for leave to appeal with the Supreme Court of Canada, on December 10, 2015.

Years earlier, in 2012, the FSCO arbitrator stated that “Allstate’s failure to provide Ms. Klimitz with Dr. Moddel’s report did not detract from the clarity and certainty of its refusal to pay the benefit.”

Asking Allstate to provide the neurologist’s report alongside its notice of denial “would amount to holding the insurer to a standard of perfection,” according to the FSCO arbitrator in 2012.

In her writing, Justice Horkins said: “In essence, it is Allstate’s position that the obligation to provide the insured with a clear and unequivocal denial does not include a requirement that it comply with the statutory obligation to provide the insured with copies of the medical reports within five days of receipt.”

Furthermore, she added that Mr Blackman found the arbitrator erred, as an insurer must “give reasons” for a claimant’s ability “to decide whether to challenge its denial.”

The director’s delegate cited a ruling from the Court of Appeal for Ontario, from 2005, in the case of State Farm Mutual Automobile Insurance versus Deborah Turner.

Justice Horkins further wrote in 2014: “The Director’s Delegate found that requiring Allstate to provide an actual copy of the medical report, upon which Allstate was basing its refusal, was not an onerous task nor did it hold the insurer to a standard of perfection.”

After hearing Allstate’s application for judicial review, other judges (Mr. Justice Frank Marrocco and Mr. Justice James Spence) agreed.

According to the Divisional Court, “no clear link” exists in SABS “between production of the medical reports and the commencement of the limitation period, the Schedule does not require reasons in the Denial Notice and as stated in Turner the reasons have a purpose. The reasons that Allstate provided did not fulfill this purpose because Allstate did not provide Ms. Klimitz with Dr. Moddel’s report.”




New Crosswalk Law Could Cost Motorists $500 Fine

New Crosswalk Law Could Cost Motorists $500 Fine

A new law in Ontario means that drivers who don’t wait for pedestrians to completely cross the road at certain crosswalks could be hit with hefty fines.

The law, which came into effect on January 1, 2016 is specifically for crosswalks in school crossing zones with guards and crossovers with lights. The hope is to make the roads safer for schoolchildren, crossing guards, and pedestrians.

Drivers who do not wait for pedestrians to completely step off the road before they continue driving may end up facing a fine between $150 and $500. That number is doubled when the law is broken at a school crosswalk. With the new law, once the pedestrian is on the roadway, traffic must stop in both directions.

But, Toronto drivers and pedestrians are skeptical it will work. Many believe the new law will be difficult to enforce. One Toronto taxi driver told CBC News that people tend to pass through red lights, so he doesn’t think the police will be able to keep up with it all, especially in the downtown core.

It will be interesting to see how the new law pans out over the next few months. It’s easy to spot an infraction and simple to follow – just wait for the person walking to step off the road before hitting the gas – but will drivers follow the rules?

We are proud to be a corporate member of the FAIR Association of Victims for Accident Insurance Reform

Victims of motor vehicle accidents are often treated unfairly by the auto insurance industry. In addition to suffering physical and psychological trauma as a result of their accidents, they are denied timely access to the funding they need and are entitled to.

We are proud to be a corporate member of the FAIR Association of Victims for Accident Insurance Reform – an organization devoted to making the voices of accident victims heard. FAIR’s advocacy activities include maintenance and promotion of their website, the publication of news releases and education/awareness materials, attendance at government agency consultations and participation in radio talk shows.

People who are involved in accidents can be unpleasantly surprised when it comes to dealing with their insurance companies. FAIR is committed to raising public awareness of this problem, advocating with legislators, and ensuring that accident victims are treated with dignity and respect.

For more information about FAIR, and to find out how you can get involved, visit their website at

Bill 30: Patching Up Ontario’s Road Efficiency

Ontario’s road system has several issues that have persisted for years. Amongst these problems are inadequate driver education and inefficient accident response management systems.

Bill 30, the Highway Incident Management Act, is a private member’s bill designed to fix problems plaguing Ontario’s roads and highways after the recently passed Bill 15, aimed at reducing insurance rates, failed to do so. Bill 15 was passed with no public consultations or input from consumers.

Inadequate driver knowledge of how to behave in car collisions has contributed to accident clean-up delays and the province’s driver education system is to blame. If the Ontario Legislature passes Bill 30, the government would be required to establish an advisory committee within two months. This committee would report and advise on issues regarding public education programs to improve driver behavior in automobile accidents. Within two months of the committee issuing its advice, the Transportation as well as Community Safety and Correctional Services Ministers would have to publically recommend or decline the recommendations.

The Bill also aims to improve accident response efficiency by establishing a committee of traffic incident management experts that would advise on highway accident detection and clearing issues. The Bill also intends to organize tow truck response arrival to accidents. Currently, the tow truck response system is uncoordinated, causing hazards and road congestion as multiple tow truck drivers race to the scene of the accident, each hoping to be the first to secure the job. With the new system in place, tow trucks would adhere to an organized system that ensures qualified tow truck drivers are retained for specific types of accidents. The government ought to make sure that the two truck drivers do not abuse customers by requesting payments in cash. That has been prohibited by government bill and car owners should consider filing a complaint if their vehicle is not released to them on credit or debit card payment.