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UPDATE: Downer v. Personal Insurance
by Michael Kennedy
May 10, 2012

Justice Murray of the Ontario Superior Court of Justice held on August 23, 2011 that an assault during an attempted car-jacking qualified as an accident pursuant to the Statutory Accident Benefits Schedule. A synopsis of this decision and its implications for the insurance industry was reported in the October 2011 edition of McCague Borlack's Transportation Newsletter.

The Personal Insurance Company appealed Justice Murray's ruling and, on May 9, 2012, the Ontario Court of Appeal overturned Justice Murray's decision, in part.


Recent Decision: Case Summary: Aweys and Intact Insurance
April 15, 2012

Arbitrator Richard Feldman released the decision in Aweys and Intact Insurance on March 19, 2012.

Four Insurance companies brought a motion for a stay of proceedings in 15 arbitration cases pending at the Financial Services Commission of Ontario (FSCO). The motions were heard together.
 
The cases all involved claims for statutory accident benefits submitted by or on behalf of insured persons from three rehabilitation facilities.
 
The Insurers take the position that the Facilities are related to each other and that many of the claims submitted were of dubious merit, that the Facilities engaged in conduct that was deliberately intended to unjustly enrich the Facilities, and in some instances, allegations of misrepresentation to the Insurers.

FSCO Counsel Meeting Summary: How to address the mediation backlog
April 09, 2012

At McCague Borlack LLP, one of the ways our Accident Benefits team keeps track of the current issues and developments at the Financial Services Commission of Ontario (FSCO) is by having a representative attend their counsel meetings which occur every other month.  At the meeting held on March 30, 2012, the main topic was How to address the mediation backlog.

While the volume of Applications for Mediation being filed and the limited number of FSCO mediators available to handle them are the primary source of the problem, this article will address three factors that are exacerbating the problem.


A Challenge to Anonymity for Donor Offspring
March 31, 2012

The British Columbia Adoption Act1 and Adoption Regulation2 provide adopted children with access to medical and social information about their biological parents. But the same legislation and its associated regulations fail to include children conceived through sperm or egg donors, keeping them from accessing this information.

In a groundbreaking ruling, the Court ruled that certain provisions within this legislation discriminate against donor offspring vis-à-vis adopted children, even though both groups have similar needs for information about biological parents...


Concussions and Injuries in Canadian and American Contact Sports: A Legal Perspective
by James Tomlinson
March 28, 2012

The prevalence of concussions and other head injuries suffered by athletes in contact sports, such as football, hockey and soccer, has garnered significant attention in Canada and the United States of America (USA). An athlete’s decision to return to play following an injury typically involves multiple parties, such as the coach, team, sports organization or school board, thus, exposing these parties to potential legal liability.

Therefore the question that emerges is which of these parties, or a combination thereof, bears the legal responsibility for the injuries suffered by these athletes?


Product Liability Claims in Sports: The Decision in More v. Bauer Nike Hockey Inc.
March 28, 2012

In Canada, all amateur hockey players playing organized hockey are required to wear a Canadian Standards Association (CSA) approved helmet. Indeed, while CSA approved helmets are required, any helmet lacking CSA approval is a prohibited product under the Hazardous Products Act and is not permitted to be sold in Canada. Given the popularity of ice hockey in Canada and the risk of serious injuries, such as concussions, while playing hockey, it is not surprising that manufacturers of ice hockey helmets are open to potential liability in negligence for the design and manufacture of their products.


Bad faith is not a claim governed by the insurance contract
by Michael Kennedy
March 25, 2012

The Ontario Court of Appeal released a decision on March 22, 2012, that deals with an insurer's alleged failure to settle a third party claim in a timely manner. The court decided that this claim for "bad faith" is not a breach of contract, but rather a breach of the independent duty to act in the utmost good faith.

Dundas v. Zurich Canada (2012 ONCA 181) involved a motor vehicle accident in which plaintiffs sued an at-fault motorist for an amount in excess of the insured's policy limits. Read why this case is important to the insurers...


Apportioning Liability in Single-Vehicle Accidents: The Clash between Contributory Negligence, the Driver’s Liability, and a Municipality’s Duty of Care
March 01, 2012

When single-vehicle accidents lead to a fatality, apportioning liability is often a daunting task for courts to undertake. In Morsi v. Fermar Paving Ltd., the Ontario Court of Appeal overturned a trial judge’s decision. This case is significant for the insurance industry as it reaffirms the duties owed by municipalites and outlines the test that courts take when apportioning liability in a single-vehicle accident.


Accessibility for Ontarians with Disabilities Act: How to Comply with the Customer Services Standard
February 29, 2012

The Accessibility for Ontarians with Disabilities Act (AODA) came into force in 2005 with the goal of making Ontario completely accessible for persons with disabilities by January 2025. The AODA mandates the creation of standard development committees in five general areas: Customer Service, Transportation, Employment, Information and Communication and Built Environment.

To date, only the Customer Service Standard has been enacted, with the Accessibility Standards for Customer Service Regulation (CSS) coming into force on January 1, 2008. The CSS sets out the requirements for ensuring that providers of goods and services in Ontario have policies in place that accommodate the needs of customers with disabilities.

Starting on January 1, 2012, almost all businesses operating in Ontario will be required to comply with the CSS. The CSS applies to: 


Recent Decisions: Mediations not occuring within '60 days' deemed to have failed
February 24, 2012

Two recent decisions, one of the Ontario Superior Court, the other an arbitral decision of the Financial Services Commission, have interpreted the “60 day” mediation provisions at section 19 of the Dispute Resolution Practice Code as mandatory. Where mediation does not occur within 60 days, the mediation is deemed to have failed, and the insured person may pursue arbitration or litigation. Read full article including the case summaries...


Case Study - Kusnierz v. Economical - Decision from the Court of Appeal
January 06, 2012

On December 23, 2011, the Ontario Court of Appeal released its decision in Kusnierz v. Economical, 2011 ONCA 823 dealing with the issue of whether a trier of fact is to combine physical and psychological impairment when determining whether a person is “catastrophically impaired” as it relates to "impairment of the whole person" under section 2(1.1)(f) of the Statutory Accident Benefits Schedule (SABS).   Read the full case summary... | Read the Court Decision...


The Interpretation of Contracts: When Courts refuse to use Extrinsic Evidence
January 01, 2012

When litigation arises regarding the proper interpretation of a contract, a common question courts consider is whether extrinsic evidence can be used to vary or modify seemingly unambiguous terms of the binding agreement. SeaWorld Parks & Entertainment LLC v. Marineland of Canada Inc., 2011 ONCA 616, is a recent example of an appellate decision that deals with this issue.

In this case, emotions were heightened and the stakes were high, as the contract in question involved two competitors who entered into an agreement to loan each other marine animals...


Insurance coverage for injuries caused by at-fault uninsured, inadequately insured and unidentified motorists
November 09, 2011

What happens when an at-fault party has no insurance or may be inadequately insured. Or where an unidentified motorist is at-fault (as in the case of a hit-and-run) there may be no practical means of securing compensation for an injury as the at-fault party and his insurer may never be identified...  The system in Ontario has two mechanisms for dealing with such scenarios.


Recent commentaries on the deductibility of collateral benefits in income loss claims
November 09, 2011

Black's Law Dictionary defines the collateral source-rule, also known as the collateral benefits rule, as “the doctrine that if an injured party receives compensation for the injuries from a source independent of the tortfeasor, the payment should not be deducted from the damages that the tortfeasor must pay.”1 Over time, this rule has evolved to allow tortfeasors and/or their insurers to deduct certain amounts already received by the plaintiff in order to ensure that the plaintiff does not receive double recovery.


Videotaping Defence Medical Examinations: An Overview of the Case Law
by Alan S. Drimer
November 09, 2011

In a personal injury action, the defence medical examination (“DME”) is the most potent tool that a defendant has to test and respond to a plaintiff’s allegations. Plaintiff counsel have increasingly been requesting, and receiving, court orders that DMEs be videotaped. This has naturally caused concern among defence counsel.