Personal Injury and Insurance Claims
Personal Injury and Insurance Claims
INSURANCE AND THE LAW: Most people have insurance to protect in the event of unfortunate events. Car insurance is mandatory and is the basis for many claims which end up in court. If you are responsible for an injury to another person your liability coverage will defend you against claims made and pay those claims to the extent of your insurance policy limits when there is a settlement or a court finding of fault. Your insurance company has a duty to you as its insured to provide coverage as set out in insurance policies. If your own property is damaged or destroyed and it is insured your insurer will investigate the claim and if it is satisfied that the claim is a proper one and coverage exists it is to pay you to the extent of your coverage. The measure of damages and conditions and exclusions are set out in your insurance policy which is a contract. Your insurer has a duty to be fair and reasonable in its dealings with you and handling of your claims. If it fails to do that and denies your claim for reasons which appear improper see a lawyer. If your insurer is treating you in a way you do not understand speak to your insurance broker who may advise you and if you have a serious concern consult with a lawyer. On February 22, 2002 the Supreme Court of Canada ruled in a case Whiten v. Pilot Insurance upholding a jury award to an insured by the insurer of one million dollars punitive damages on top of actual damages. In that case this Ontario insurance company (owned by Aviva) dealt unfairly with its insured on a home fire insurance claim. The facts are extreme. This precedent setting case has resulted in insurers being more careful in how they treat their insureds. In similar cases against other insurers large punitive damage awards have been given. Cases where punitive damages are awarded in Canada are still uncommon and they require almost malicious conduct by the insurer. Contact a Plaintiff's insurance law specialist for advice in situations which you think involve extremely unfair treatment by an insurance company. WE ACT IN A WIDE RANGE OF INJURY CLAIMS:
Murray Miskin is well known for his expertise in Insurance Law. He is a past Chair of the Ontario Bar Association's Insurance Law Section and the Canadian Bar Association's National Insurance Law Section. He is Chair of the CBA's National Sections Council for 2007-2009 a body co-ordinating all areas of legal practice in Canada. Murray is also a member of the Canadian Bar Association's Board of Directors and its Finance Committee. In his law practise he works primarily for people with claims against insurance companies rather than for insurance companies defending such claims. If you have an insurance claim you need a lawyer who believes in you and is on your side. Michelle Brown is experienced at defending insurance claims from the time before she joined our firm but for the past two years she has been primarily acting for injured people making insurance claims. Michelle's defence experience and insight has strengthened us in our skills used bringing successful insurance claims. If you have an insurance policy for benefits to be paid in case of loss or injury and the insurer refuses to pay you may get a free first consultation to learn your rights. Do not wait because there are time limits for court claims under most policies. If your remedy is through the courts our firm can commence an Ontario court action on your behalf. If the claim is in another jurisdiction a local lawyer there can be brought in when necessary. Murray Miskin, through twenty years of active involvement in the Association of Trial Lawyers of America has a network of American lawyers and legal research facilities at his call in every U.S. jurisdiction. These are also lawyers who work for people's rights and justice who will be on your side when brought into the case. That association was recently renamed the American Association for Justice (AAJ). This expertise has enabled us to assist Canadian "snowbirds" and others visiting the USA who have accidents or legal issues. We are developing expertise in Hurricane Insurance Claims and will be ready in the event work related to those claims is required. Until now there have not been lawyers in Canada equipped to assist Canadian homeowners in Florida, the Carolinas and elsewhere with hurricane damage claims. Similarly, Murray Miskin is frequently called upon by U.S. lawyers needing help with Canadian law or legal action that must be brought in Canada. Through the Canadian Bar Association Murray has developed a network of lawyer contacts across Canada and links with American lawyers involved in the American Bar Association.
Some injury claims are dealt with by Public organizations such as Criminal Injuries Compensation and Worker's Compensation. We do handle claims to the Criminal Injuries Compensation Board but in many cases we will encourage people to apply on their own due to the limited compensation making it uneconomical to hire a lawyer. The Workplace Safety and Insurance Board (W.S.I.B.) used to be known as the Workers' Compensation Board (W.C.B.). It is a government managed insurance scheme of no-fault benefits for persons injured while in the course of their employment. It is funded by employer premiums but the system has taken away the right to sue employers for compensation. This includes other employers than the injured worker's own employer. The system is complex and bureaucratic so that legal advice is a good idea. We often run into cases where there is an overlap between the right to sue and the right to claim compensation. In those cases the injured worker is allowed to "Elect" whether to receive benefits or sue. Always get legal advice before making a decision. Many legal claims against insurers are for personal injury through the negligence of another person or a company. Usually such claims, legally called Tort Claims, are defended by insurers representing the person at fault and providing liability coverage to pay the claim. These claims are not against your own insurance but under the liability coverage of another person's policy. That coverage is there to protect individuals from claims brought by others against them. If you are bringing such a claim remember you are not dealing with your own insurer and be more guarded. The first duty of the other insurer is to their own insured and not to you. For such claims a lawyer is usually necessary. If the other party has no insurance there may still be a remedy through insurance so please investigate with legal advice all serious claims you may have. Put experienced trial lawyers on your side through the Miskin Law Offices. Now most cases are settled through negotiation, mediation or arbitration without court. That is a specialty area of Murray Miskin who is particularly effective because of his known court experience and record of persistence and success. HOME INSURANCE POLICIES INCLUDE COVERAGE FOR LIABILITY CLAIMS BY PERSONS INJURED ON OR OFF THE OWNERS' PROPERTIES. THIS INCLUDES A WIDE RANGE OF ACCIDENTS AND INJURIES CAUSED BY PETS OF THE HOMEOWNER. FAMILY MEMBERS RESIDING IN THE HOME MAY NOT MAKE CLAIMS UNDER THIS COVERAGE.
Our office has dealt with very serious injuries by guests in homes including stairway falls, swimming pool accidents, and falls from decks. Persons who go to premises uninvited to make deliveries or visit can make claims for injury cause by falls on icy driveways, decks, pools and other incidents.
Dog Bites are serious matters which traumatize victims permanently and leave horrible scars. Bites to children are especially upsetting. Some dog bites result in death or permanent disability. Our office has represented many dog bite victims and we never ask for a retainer or fee until such a claim is settled. In Ontario, the Dog Owners Liability Act imposes strict liability on dog owners for injuries caused by dogs with very few exceptions. We handle these cases on a contingency fee basis. Where a child is the victim we act on the basis that all legal fees are paid by the insurer who pays the full claim with no deduction of money paid for the child. Money for the benefit of children is held by the court and earns interest until the child is 18 years old. All settlements for children require court approval including approval of the legal fees paid. If a claim is made against you report it to your broker or insurer and they will handle it on your behalf and appoint and pay for a lawyer if one is needed. It is important to have adequate home insurance coverage even if you are a tenant to protect you from this type of claim. Ask your broker about Umbrella Policies which offer greater combined coverage for both home and auto claims. Our office represents people who make home insurance injury claims on a contingency fee basis. You may bring a claim against a friend or relative on their home insurance policy without harm to the person you are claiming against. Their insurance policy will cover them and unlike auto insurance their premium will not normally go up based on the claim. Hopefully they will understand the need for compensation and remember it is the insurance company who is responsible for defending and paying genuine claims.
Auto Accidents:
One of the most complex areas of legal practice in Ontario, Canada is now auto accident injury claims.
This includes all injuries from accidents involving automobiles including
injuries to pedestrians and bicyclers. Due to the "no fault"
benefit system people must often look to their own auto insurer for much and sometimes all of their compensation.
If they do not have auto insurance they can get these benefits from the insurers
of autos involved in the accident.
Where there are accident benefits in dispute there is a system of mandatory mediation with independent Government
mediators who often help bring about a compromise or other settlement. It is important to have legal representation at mediation
and all settlement agreements have a two day "cooling off" period where you may change your mind. If mediation fails to resolve a dispute
you can choose to go court and sue or go to a privately paid or Government
employed arbitrator. Private arbitration of accident benefit claims is
rare because of the low cost and efficient service available through the
Financial Services Commission of Ontario. The applicant insured pays only
$150 to commence the process while the insurer must pay $3000. In the end
a costs award may be made against either party so frivolous arbitration claims
are not encouraged. Arbitrators are independent people who usually have
experience and expertise in the subject area of the dispute. For
accident benefits for accidents after October 31, 1996 that there is an option of
private arbitration.
The right to sue the at-fault driver or owner and their insurer has not been taken away but has been limited. That limitation
which came into effect for accidents from June 22, 1990 was changed on January 1, 1994 and again on November 1, 1996.
Further changes and limitations to the right to sue were brought in effective October 1, 2003. To understand your rights
under any of the systems you need legal advice from an experienced lawyer whose focus in on this type of work.
To summarize your right to sue the at-fault driver in Ontario and accident benefits available you may click on the relevant dates:
1. Accidents before June 22, 1990.
5. Accidents since October 1, 2003...
For this most recent system we do not have a full web page. It is a
modification by the former Harris/Eves Government from 4. above which defines a
tougher threshold and increases
the deductible on injury claims for pain and suffering from $15,000 to $30,000 with the intention of
preventing most claims from proceeding We had expected further changes from Ontario's Liberal Government of Dalton McGuinty but no new policies have yet been proposed, but some are likely before the end of the McGuinty government's second term in office which comes in Fall 2011.
Fault for an accident may sometimes be split between drivers and it is important to claim against
all of the right people. The person charged by police is not always 100% at
fault in a civil claim. If you are a passenger
you may bring a claim against the driver even if it is your vehicle of a friend or member of your family driving. Some people are reluctant
to being such claims, but should remember it is really the insurance company who responds to (and pays) the claim
not their friend of relative. Lawyers meeting with injured drivers and passengers together must be careful to avoid conflict and sometimes
can not represent or even meet with both.
Where an accident is caused by an unknown, uninsured or underinsured driver there is usually a right to claim from your own or another insurer. Where
there is no insurance at all available there is an Ontario Government fund available. That fund may be involved and pay a claim, for example where a
pedestrian or bicyclist with no auto insurance is struck by an unknown hit and run driver.
Most of us pay for auto insurance which is mandatory in Ontario and its purpose is to protect you from claims
by others based on your fault for an accident.
Minimum policy liability limits are $200,000.00 but most people carry $1,000,000.00. One million dollars or
more liability coverage does not cost much more than the minimum and is highly recommended. You
liability coverage will protect you and extend to you as a claimant if the
person at fault is uninsured, unknown or underinsured.
The insurance is there to provide benefits in the event of damage, bodily injury
or death. When we buy insurance we also pay for the right to sue and get paid by
an insurer for pain and suffering and other losses. We strongly recommend that you see a lawyer as soon as possible after an accident involving
The above information relates to auto accidents in Ontario, Canada. The situation becomes even more complex where the accidents
take place in, or people involved are from other Provinces or States. We are
frequently involved in such cases and would be pleased to consult with you for a free first
and sometimes second meeting to determine your rights.
We have acted in a number of serious burn cases
from fires and explosions. These incidents may be due to the negligence of
an insured person or company and we would be pleased to meet with you to discuss
possible claims. We are familiar with the extreme form of injury which can
be caused by fire.
Call to speak to Anna at (905)430-8880, Ex. 118 or email us:
questions@adrworks.com.
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biting dogs
Work
Injuries
Criminal
Injuries
If your accident is one where you have the right to sue, or believe you do,
there is a time limit for starting your claim in court. It is usually two years
from the date of the accident but sometimes is less. It is important to give
notice of your claim as early as possible and within four months of the accident
if the accident is November 1, 1996 or after. Notice letters are usually sent by
lawyers to meet the legal requirements which include disclosure of medical
records and other documents once notice is given.
Fires and explosions
can be fatal or cause very severe injury