Our Personal Injury Guidebook

Our Personal
Injury
Guidebook
Partnering with you on
your road to recovery
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Table of Contents
Injured? You Must Take the Following Steps . . . . . . . . . . . 3
Our Promise to Our Clients . . . . . . . . . . . . . . . . . . . . . 4
At Mazin & Associates PC You Can Expect . . . . . . . . . . . . 5
Policy Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Commencing a Court Action . . . . . . . . . . . . . . . . . . . . 7
Time Limits on Claims . . . . . . . . . . . . . . . . . . . . . . . . 8
Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Important Links . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Injured? You Must Take the
Following Steps
1. Contact the Police and advise
from the accident – be sure to
them of all accident related
also keep track of the dates and
details.
times of your visits.
2. Write down the names
7. Ensure that caregivers,
and contact information of
whether professionals, friends
everyone involved in the
or family members, record the
accident and any witnesses;
time that they spend caring for
if you are involved in a motor
you and the activities that they
vehicle accident, obtain the
help you with.
insurance information as well
8. Investigate whether you are
as the driver’s licence and
eligible for treatment coverage
licence plate numbers of all
or disability pay under any
other involved parties.
other insurance policies –
3. See your family doctor and
check with your employer,
advise them of your injuries.
4. Notify your Accident Benefits
Insurance Provider of your
your school and/or private
plan providers.
9. Keep the original receipts and
involvement in a motor vehicle
invoices of all of your out-of-
accident as soon as possible.
pocket expenses related to your
5. If you are unable to work or go
accident, including payment
to school, notify your employer
for caregiving, medication,
or school and advise them of
assistive devices, etc.
the reason for your absence.
6. Keep track of the names of all
health professionals that you
see in relation to your injuries
10. Contact Mazin & Associates
PC to discuss your legal rights.
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Our Promise
to Our Clients
»» We will ensure that all steps are taken in order for you to be fairly
compensated for the injuries that you sustained
»» We will meticulously investigate your accident to properly
determine liability
»» We will protect you from agreeing to an improvident settlement
»» We will study every aspect of your case to ensure that it is
accurately evaluated
»» We will help to coordinate your medical treatment and ensure that
you are getting the treatment you deserve
»» We will not shy away from taking your case to trial if the insurer is
being unreasonable.
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At Mazin & Associates PC
you can expect
Reliability
A team
approach
Trustworthiness
Compassion
Experience
Understanding
Tough
negotiators
Open door
policy
Results
Attention
to detail
Practice Areas:
»» Automobile
»» Critical Illness
Accidents
»» Product Liability
»» Bicycle Accidents
»» Disability
»» Boating Accidents
Insurance Claims
»» Brain Injuries
»» Life Insurance
Claims
»» Spinal Cord
Injuries
»» Medical
Malpractice
»» Property
Accidents
Nursing Home
Negligence
Pedestrian
Accidents
»» Slip and Fall
»» Motorcycle
»»
»»
Insurance Denials
Accidents
»» Wrongful Death
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Policy Changes
Most people renewing their auto
insurance policy are looking to
save some money today but do
not realize that in the event of
a serious but non-catastrophic
injury, the minor amount of money
that they will save now will cost
them the benefits that they will
desperately need later . If a person
has not paid for optional benefits
coverage, they will only be eligible
for the statutorily mandated
reduced benefits and may suffer
significant hardship obtaining
adequate care and treatment .
What Changed?
On September 1, 2010, a new law
came into effect in Ontario, which
effectively reduced your entitlement
to Accident Benefits . Previously,
non-catastrophic victims of motor
vehicle accidents were entitled
to claim compensation for the
following:
» Income replacement at the rate of
80% of their net weekly income, up
to a maximum of $400 .00 per week .
» Assistance with housekeeping and
home maintenance tasks, up to a
maximum of $100 .00 per week .
» Assistance with care giving
tasks, if the insured person was a
primary caregiver .
» Assistance with personal care up
to a maximum of $72,000 .00, over
a period of 10 years .
» Medical and rehabilitation
treatment up to a maximum of
$100,000 .00, over a period of
10 years .
How will this
Affect you?
As a result of the new
changes in the law, the
average insurance policy now
entitles the insured to the
following reduced benefits
in non-catastrophic injury
cases:
» Income replacement at the
rate of 70% of their gross
weekly income, up to a
maximum of $400 .00 per
week .
» Assistance with personal
care up to a maximum of
$36,000 .00, over a period
of 10 years .
» Medical and rehabilitation
treatment up to a
maximum of $50,000 .00
over a period of 10 years,
with most whiplash and
sprain/strain-type injuries
falling under the new
Minor Injury Guideline
and as such, being entitled
to a maximum of only
$3,500 .00 for treatment .
Commencing a Court Action
In most cases, if another person or party is or may be at fault in an
accident, the injured victim of the accident has the right to commence
a lawsuit against the at-fault party and recover compensation for the
damages they sustained as a result of their personal injuries.
How to Proceed
with a Claim?
»» Retain Mazin & Associates PC to
advance your claim. With us on
your side, you will never be alone.
»» We will provide potential
Defendants with written notice of
your intention to sue, within the
prescribed time limits.
»» We will commence a lawsuit
against potential Defendants
within the prescribed time limits.
»» We will fight for the care and
compensation you deserve.
What types of claims can
you make?
»» You can claim compensation for
your pain and suffering sustained
as a result of your accident. In
motor vehicle accident cases,
a claim for pain and suffering
must first “meet the threshold”
by proving that the injury or
disfigurement that you have
sustained is both permanent and
serious and that your impairments
are to important physical, mental
or psychological functions. In
some cases, compensation for
pain and suffering may be reduced
by a statutory deductible. In
motor vehicle accident cases,
a Plaintiff’s claim for pain and
suffering is capped.
»» You can claim compensation
for your past and future loss of
income and loss of competitive
advantage sustained as a result of
your accident. In most cases you
must first seek compensation for
income loss from any extended
or disability insurance policy
under which you may be covered.
In motor vehicle accident cases,
you must also seek compensation
from your Accident Benefits
Insurer before you can claim
compensation in a lawsuit.
»» You can claim compensation for
the costs of housekeeping and
home maintenance expenses
sustained as a result of your
accident. You are only entitled to
make a claim for these costs if you
are unable to maintain your home
as you did before your accident.
In the case of motor vehicle
accidents, you must first claim
these costs from your Accident
Benefit Insurer, if you have paid for
the optional benefits that would
entitle you to claim these costs.
»» You can claim compensation for
the costs of your past and future
medical and rehabilitation care
sustained as a result of your
accident. All expenses that are
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not covered by OHIP or by your
Accident Benefits Insurer can
be claimed.
»» Claims sustained by your family
members as a result of your
accident. Family members can
make claims with respect to
loss of your care, guidance and
companionship. Further, family
members can also make claims
with respect to the economic
loss that they have sustained and
any out-of-pocket expenses that
they have incurred as a result of
the care that they have provided
for you. Your family members’
claims may be subject to a
statutory deductible.
Time Limits on Claims
If you are injured, it is important
to keep note of the following time
limits as missing any of these
could negatively affect the success
of your claim and in some cases,
may even completely bar you from
obtaining compensation.
If you are injured
in a motor vehicle
accident:
1. You must inform your Accident
Benefits Insurance Provider
of your involvement in an
accident within 7 days of
the collision.
2. You must complete your
Application for Accident
Benefits (OCF-1) within 30
days of your involvement in
a collision.
3. You must apply for mediation
or arbitration, or sue within 2
years of the denial of
any benefit.
4. If you are not at fault in the
motor vehicle accident, you
must notify the at-fault driver
and any associated parties
within 120 days of the collision.
5. If you are not at fault in the
motor vehicle accident and you
intend to sue the at-fault driver
for compensation for your
injuries, you must commence a
claim within 2 years of
the collision.
6. If there is damage to your
vehicle for which you have
not been compensated and
you intend to sue to recover
compensation, your must
commence a claim within 1
year of the collision.
If you are injured
in a slip and fall
incident:
1. If you fall on city, town or
provincial property, you must
notify the appropriate authority
in writing, within 10 days of
your fall.
2. If you intend to sue the city,
town or provincial authority for
compensation for your injuries,
you must commence a claim
within 2 years of the fall.
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Glossary
Accident Benefits
Benefits provided by an injured
victim’s own Insurance Provider,
regardless of whether the
injured person is at fault for the
accident. Accident Benefits may
include the following benefits:
attendant care, caregiving, funeral
expenses, housekeeping and home
maintenance, income replacement,
lost education expenses, medical,
non-earner and rehabilitation
benefits. A claimant’s eligibility for
specific benefits depends on the
claimant’s personal policy coverage.
Activities of Daily Living
A person’s everyday ordinary
activities done to care for
themselves, their family and their
household.
Arbitration
A process by which a legal dispute
is decided and a binding decision is
rendered, without having gone to
trial.
Attendant Care
A type of benefit that is paid to
assist the victim of a motor vehicle
accident to accomplish their
Activities of Daily Living, which
the injured person cannot perform
by themselves or has difficulty
performing. The cost of providing
attendant care may be paid by a
claimant’s Accident Benefits Insurer
whether the person providing care
is a professional, a friend or a family
member. Restrictions may apply.
Catastrophic Impairment
A designation made by the Accident
Benefit Insurer for victims of motor
vehicle accidents who have suffered
the most serious types of personal
injuries, specifically: paraplegia,
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quadriplegia, amputation of arm or
leg or impairment causing the total
and permanent loss of the use of
an arm or leg, total loss of vision in
both eyes, injuries resulting in an
impairment of 55% or more of the
“whole person,” brain impairment
measured by a score of 9 or less on
the Glascow Coma Scale, Marked
or Extreme mental or behavioural
impairment, and severe disability
from a brain injury measured using
the Glascow Outcome Scale. A
person who has been designated
as catastrophically impaired,
becomes entitled to maximum
limits of $1,000,000.00 in medical
and rehabilitation benefits as
well as attendant care benefits,
and housekeeping and home
maintenance benefits are payable
for the remainder of the injured
person’s life.
Contingency Fee
A fee arrangement in which the
lawyer or law firm is paid only if
compensation is obtained. If no
damages are recovered, no monies
are owed to the lawyer or law firm
for their services.
Contributory Negligence
A defence to a claim for personal
injuries that states that if a person
was injured, in part, due to their
own negligence, the injured person
would not be entitled to collect any
or a portion of the damages from
the party that allegedly caused
the accident.
Damages
The monetary equivalent of the
losses that the Plaintiff has suffered
as a result of the injuries that he/she
sustained. The losses encompassed
include: pain and suffering, loss
of past and future income, loss
of competitive advantage, loss of
enjoyment of life as well as past
and future costs of care
and rehabilitation.
Deductible
An amount of money that is
expressly set out in an insurance
policy and that the Insurer will not
pay if the claimant claims against
the policy.
Deductible (Statutory)
In lawsuits for personal injuries
sustained in a motor vehicle
accident, a deductible refers to an
amount of money that is mandated
by statute, by which, in some cases,
the damages award may be reduced.
Defendant
The party that is being sued by
the Plaintiff and that is allegedly
responsible for the Plaintiff’s
injuries and damages. In motor
vehicle accident cases, most
Defendants are insured and it is
their Insurer that effectively defends
the claim on their behalf.
Disbursements
Plaintiff
Expenses incurred by a lawyer or
a law firm to advance a client’s
claim. These expenses include:
photocopying, postage, process
server fees, obtaining medical
records, etc.
The party that initiates the lawsuit.
Incurred Expense
This is statutorily defined as
requiring the injured person
to pay or promise to pay for
services received and requiring
the service provider to either
perform the services in the course
of employment, occupation or
profession or to prove that they have
suffered an economic loss as a result
of providing the services.
Limitation Period
The statutorily mandated time
period after which a lawsuit can no
longer be commenced. In the case
of most accidents, the limitation
period expires exactly two years
from the date of the accident.
Minor Injury
A statutorily mandated definition
for injuries which include: sprain,
strain, whiplash associated disorder,
contusion, abrasion, laceration or
subluxation and any clinically associated sequelae. An injured person
who is designated to have sustained
a minor injury is only entitled to a
maximum of $3,500.00 for medical
and rehabilitation benefits.
Threshold
The benchmark by which a claim
for personal injuries sustained
in a motor vehicle accident is
evaluated. In order to “meet the
threshold,” a person’s injuries
and/or disfigurement must be
both permanent and serious and
their impairments must be to an
important physical, mental or
psychological function.
Tort
An area of law that involves an
injury or wrong committed by
one party or multiple parties
against another, through their
negligent acts or omissions, which
results in harm. In motor vehicle
accident cases, the Tort must
be distinguished from Accident
Benefits, which are paid to injured
victims regardless of fault.
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Important Links:
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Legal
The Canadian Bar Association
www.cba.org/
Law Society of Upper Canada
www.lsuc.on.ca/
Health Canada
www.hc-sc.gc.ca/index-eng.php
Ontario Ministry of Health and Long-term
Care
www.health.gov.on.ca/en/
Ministry of the Attorney General
www.attorneygeneral.jus.gov.on.ca/english/
Brain and Spinal Cord Injuries
Ontario Brain Injury Association (OBIA)
www.obia.ca/
The Ontario Bar Association
www.oba.org/
Brain Injury Society of Toronto (BIST)
www.bist.ca/
Insurance and Financial Services
Canada Pension Plan (CPP)
www.servicecanada.gc.ca/eng/isp/cpp/cpptoc.
shtml
Financial Services Commission of Ontario
(FSCO)
www.fsco.gov.on.ca/en/Pages/default.aspx
Ontario Health Insurance Plan (OHIP)
www.health.gov.on.ca/en/public/programs/
ohip/
Insurance Canada
www.insurance-canada.ca/
Registered Insurance Brokers of Ontario
www.ribo.com/
Workplace Safety and Insurance Board
Appeals Tribunal
www.wsiat.on.ca/english/appeal/
Medical
Canadian Medical Association (CMA)
www.cma.ca/
College of Physicians and Surgeons of
Ontario
www.cpso.on.ca/
Brain Injury Association of WaterlooWellington
www.biaww.com/
Brain Injury Association of Peel-Halton
www.biaph.com/
Community Head Injury Resource Services
of Toronto (CHIRS) www.chirs.com/
Toronto Acquired Brain Injury Network
www.abinetwork.ca/
Spinal Cord Injury Ontario
http://www.sciontario.org/
Canadian Spinal Research Organization
(CSRO)
www.csro.com/
SCI Action Canada
www.sciactioncanada.ca/
Pain Related:
North American Chronic Pain Association
of Canada www.chronicpaincanada.com/
The Canadian Pain Society
www.canadianpainsociety.ca
The Arthritis Society
www.arthritis.ca
Causes Close to Our Hearts
»» Brain Injury Association of WaterlooWellington
»» Brain Injury Association of Peel-Halton
»» Ontario Brain Injury Association
»» Sick Kids Hospital
»» Spinal Cord Injury Ontario
»» Alzheimer’s Society of Canada
»» World Vision
TO LEARN MORE VISIT OUR WEBSITE: mazinlawyers.com
OR CALL US FOR A FREE CONSULTATION ANYWHERE IN ONTARIO
1.800.432.HURT • 416.250.1234
5 Park Home Avenue, Suite 120, Toronto, Ontario M2N 6L4