New Accident Benefit Dispute Regime Burdens Applicants, Law firms

A new system that came into effect April 1 will see accident benefits disputes head to the Licensing Appeals Tribunal (LAT) instead of the Financial Services Commission of Ontario (FSCO) — but as Toronto personal injury lawyer Darryl Singer tells Law Times, he already has a number of key concerns with the new process.

While the system promises a speedy resolution of disputes, Law Times says it remains to be seen if it can deliver on its goal to resolve matters in a six-month time frame. Singer, principal of Singer Barristers Professional Corporation, says the fact that applicants have to pay a $100 fee at the start of the process is a problem.

“FSCO had no fee until an application for arbitration was made. Well over 50 per cent settled quickly at the mediation stage with no out-of-pocket disbursements. When the $100 was paid, the insurer had to file $3,000 to respond and engage outside counsel. It was a leverage to get a lot of files settled,” he says.

As Singer explains, at the LAT, insurers will also pay on a points system, proportional with their usage of the process.

“Under the old system, the payment came out of the reserve the adjuster had set aside for the file. I suspect it will now come out of a different pool and will not affect the adjusters. It is a global amount, not a file-by-file amount,” he says in the article.

Singer thinks that this will prove to be a burden for applicants and law firms who act on a contingency basis.

“It will weed out the firms that will take these files, especially the smaller, paralegal firms. It’s not economically feasible to take a lot of smaller files. The mechanism to fight them is not advantageous. We will end up like family law with so many self-represented parties,” he says.

The FSCO also had a 90-day timeline that worked out to an average of nine months.

“There are just too many applications for the resources. It won’t take very long for the back to break on this system,” he adds.

“Given how long it takes to get records from doctors, hospitals, and OHIP, the timeline isn’t ever able to be met in practical terms.”

Singer also says he is concerned that the new case conference may often be done by phone.

“There is a lot of leverage in face-to-face, in-person meetings. Until the adjuster and defence lawyer meet with the person, there is no human element. When they are there in person, they can see the person has injuries and that they will make a good witness. They see that they have some exposure and should settle. At the LAT, the case conference administrator has the sole discretion to decide whether our hearing is in person or a paper hearing,” he says.

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Local Lawyers, Paralegals Valuable to Sole Practitioner Network

Networking is an essential component of starting a law firm, and can include establishing key relationships with other local legal professionals, Toronto personal injury lawyer Darryl Singer tells Lawyers Weekly.

In 2010, Singer, principal of Singer Barristers Professional Corporation, started his personal injury practice with just one assistant. In part, he credits his firm’s growth to strong relationships with paralegals.

“As a plaintiff’s lawyer I was doing tort cases, and in the first two or three years I had an association with a paralegal firm that kept the accident benefit work and sent me the tort work,” he says in the article.

“Their scope of practice is limited, so if they hit the ceiling and can’t do something they call me.”

Singer also says that he turned former personal injury competitors into referral sources.

“I’ve developed a network of a dozen of these firms…that won’t take a case if the claim isn’t worth ‘X’ dollars,” he explains, adding that some firms focus on higher-end tiers within their niche.

Now, Singer’s firm includes an associate lawyer, five paralegals and law clerks.

When it comes to hiring, Singer says his associate lawyer joined as an articling student and remained with the firm after she was called to the bar.

“I don’t use a recruiter,” he says. “It’s almost always connections through people I know.”

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Liability Denials Likely After Toronto Cops End Minor Crash Probes

A decision by the Toronto police to stop attending minor crashes could make it easier for parties to deny fault and liability — raising barriers for people who are hurt in an accident, personal injury lawyer Darryl Singer tells AdvocateDaily.com. WATCH CityNews.

“What appears to be a minor accident may result in injuries that are anything but minor,” says Singer, principal of Singer Barristers Professional Corporation in Toronto.

Facing an increasing volume of minor collisions, the Toronto Police Service announced Tuesday it would stop investigating when the combined damage is less than $2,000.

Traffic officers say about 70 per cent of all crashes are minor, and the current model is “no longer sustainable,” the Toronto Sun reports. The new hands-off approach is expected to begin next week.

Singer, who represents people who have been hurt in motor vehicle accidents, says the move could lead to problems for individuals who are injured in so-called minor crashes.

“If you are injured in an accident, you cannot sue the other party unless they are at fault,” he says.

“Without a police officer at the scene, it will be easier for the potentially at-fault party’s insurer to defend on the basis that their insured was not actually at fault.”

Singer adds that many minor accidents involve violations of the Highway Traffic Act, such as failing to yield, improper turns and improper lane changes.

“When police attend the scene and determine this to have been the case they will issue a ticket to one of the parties,” Singer says. “If they do not attend, this may open the door for the responsible party to concoct a story to deny liability.”

Singer says he often sees long-term health issues come as a result of crashes that were once believed to be minor.

“Often the body and mind are in a state of shock at the accident scene,” he says. “Unless there are broken bones, you may not realize that you have suffered injuries that will linger for months or even years.”

Soft tissue injuries to the neck and spine may appear to be minor but are often the “most insidious,” he says.

“While broken bones will generally heal, soft tissue injuries often result in chronic physical pain, and the effect of this quite frequently leads to depression and anxiety. So you may not decide until weeks or even months post-accident that you have injuries sufficient to warrant a lawsuit,” he says.

If there is no police report, drivers need to take proactive steps at the scene of an accident, he says. Singer provides the following tips on his blog:

1) Obtain the other driver’s licence and insurance information. Simply take a photo of the driver’s licence and pink slip.

2) Make a note of or photograph the make, model and licence plate of the vehicle.

3) Take photographs of any damage on both vehicles. Include any part that is detached and is lying on the road.

4) Obtain names and telephone numbers of witnesses.

5) If you feel any pain at all on the day of the accident or within several days or weeks thereafter, immediately attend at your family doctor, emergency room, or walk-in clinic, to document the injuries. Make sure to tell the doctor the details of the accident and how these injuries arose.

6) Contact your insurance company and provide them all the details, including details of any injuries, so there is a written record of the accident.

7) Write a detailed account of how the accident occurred and what injuries you have. Make notes about whether you were wearing a seatbelt, had anything to drink, if you were using a cell phone at the time, the weather, when you first saw the other vehicle, and any other details of the accident and your injuries.

8) Make a note of any conversation you had with the other driver.

9) If your injuries are ongoing, keep a regular daily or weekly journal of the nature and progress of your injuries, including your daily pain on a scale of 1 to 10; a list of tasks you need help with; whether or not you missed work or other events; and whether or not (and how) your pain affects your relationship with those closest to you.

“By taking the appropriate steps at the time the event occurs, you will enhance your credibility in the context of the lawsuit, and increase the likelihood that a lawyer can settle or win your case,” Singer says.

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ATE insurance resolves plaintiff intimidation over trial costs

For plaintiffs who might not otherwise be able to risk an adverse costs award by going to trial, the advent of after-the-event (ATE) insurance in Ontario has levelled the playing field, Toronto personal injury lawyer Darryl Singer tells Law Times.

As the article notes, several companies in Ontario are now offering ATE insurance or indemnities that can be purchased once a case has been instigated. These products allow litigants to protect themselves from the risk of a cost order, and can also be provided as a blanket policy for a law firm that needs protection for its disbursements.

Singer explains that the importance of the product weighs in at the negotiation stage, as “cases which would not settle at mediation because the plaintiff would be intimidated by potential costs consequences now stand their ground and get the case resolved. In addition, cases that would get dropped on the eve of trial by the plaintiff can now proceed to trial.”

In a typical scenario, before companies like legal expense insurer DAS Canada and BridgePoint Indemnity Company came on the scene, Singer says the insurer, the mediator or the judge would tell clients that they might win, but if they don’t, a two-week trial could cost $100,000.

“The clients would fold like a pack of cards. This allows me as a lawyer to sit there, slap the certificate on the table, and say, ‘You don’t care if you lose and have to pay costs. Well, neither do we.’ Now the single biggest leverage they’ve got is off the table. It has taken a major weapon away from the defence side.”

Singer currently has a blanket policy that covers every personal injury file he opens.

“I pay $200 to cover up to $10,000 in disbursements with a rider that allows me to increase coverage to $50,000 without any review. If I decide that I am going to trial in a couple of weeks and the $50,000 is not enough, I can increase it to $100,000 or higher,” says Singer, who has chosen to use the indemnity product from BridgePoint.

Singer tells Law Times that he knows of firms with a higher blanket policy. “My practice has a high volume of small files. Some firms have blanket coverage of $50,000 to $60,000.”

The indemnity covers adverse costs, including defence legal fees and the plaintiff lawyers’ disbursements, but not the plaintiff lawyer’s legal fees.

Flood of special award claims unlikely to follow rare ruling

A recent Financial Services Commission of Ontario ruling to grant a special punitive award against an insurance company for its handling of a client’s application for catastrophic impairment is unlikely to open the floodgates to a rash of special award claims, Toronto personal injury lawyer Darryl Singer tells Law Times.

In Waldock v. State Farm Automobile Insurance Company, the plaintiff was helping a car stuck in a snow bank when he was struck by a vehicle that had lost control coming down a hill, the article says.

He subsequently applied for and received statutory accident benefits from State Farm, but disputes arose between the two parties about whether or not his injuries were deemed ‘catastrophic.’

In 2014, a preliminary issues hearing to determine if he was catastrophically injured ruled in favour of the plaintiff, but LawTimes reports that the arbitrator deferred the decision on hearing costs until a later date.

“When the 2014 decision was released, [Arbitrator Knox] Henry found that the insurer’s medical assessor failed to follow the accepted guidelines to determine whether a person is catastrophically impaired, and ruled the insurer based its denial of catastrophic impairment on a flawed report.”

In mid-November, the arbitrator ruled that State Farm had refused to accept his original ruling of catastrophic impairment.

“Because the insurer had ample evidence to support Waldock was in fact seriously injured and partially incapacitated by the collision, he found the company was responsible for withholding or delaying payments, and he ordered a special award of 30 per cent of the $361,520 still owing, plus accumulated interest, calculated at two per cent per month and compounded monthly starting from early July 2010. Waldock was also awarded $125,435 for his bill of costs and disbursements of $45,824,” Law Times reports.

While Singer says Waldock is not a ruling that will lead to a flood of special award claims, he tells Law Times that it is a “sound decision” that reinforces the court’s discretion in making such rare awards.

“The conduct has to be essentially so egregious; in this particular case, it should have been patently obvious to the insurer the client was catastrophically injured,” he adds.

The arbitrator ruled because the insurer decided to force the matter to arbitration, and even after the ruling on catastrophic impairment, only paid the client about a third of what was owing, Singer tells AdvocateDaily.

Flood of special award claims unlikely to follow rare ruling

A recent Financial Services Commission of Ontario ruling to grant a special punitive award against an insurance company for its handling of a client’s application for catastrophic impairment is unlikely to open the floodgates to a rash of special award claims, Toronto personal injury lawyer Darryl Singer tells Law Times.

In Waldock v. State Farm Automobile Insurance Company, the plaintiff was helping a car stuck in a snow bank when he was struck by a vehicle that had lost control coming down a hill, the article says.

He subsequently applied for and received statutory accident benefits from State Farm, but disputes arose between the two parties about whether or not his injuries were deemed ‘catastrophic.’

In 2014, a preliminary issues hearing to determine if he was catastrophically injured ruled in favour of the plaintiff, but LawTimes reports that the arbitrator deferred the decision on hearing costs until a later date.

“When the 2014 decision was released, [Arbitrator Knox] Henry found that the insurer’s medical assessor failed to follow the accepted guidelines to determine whether a person is catastrophically impaired, and ruled the insurer based its denial of catastrophic impairment on a flawed report.”

In mid-November, the arbitrator ruled that State Farm had refused to accept his original ruling of catastrophic impairment.

“Because the insurer had ample evidence to support Waldock was in fact seriously injured and partially incapacitated by the collision, he found the company was responsible for withholding or delaying payments, and he ordered a special award of 30 per cent of the $361,520 still owing, plus accumulated interest, calculated at two per cent per month and compounded monthly starting from early July 2010. Waldock was also awarded $125,435 for his bill of costs and disbursements of $45,824,” Law Times reports.

While Singer says Waldock is not a ruling that will lead to a flood of special award claims, he tells Law Times that it is a “sound decision” that reinforces the court’s discretion in making such rare awards.

“The conduct has to be essentially so egregious; in this particular case, it should have been patently obvious to the insurer the client was catastrophically injured,” he adds.

The arbitrator ruled because the insurer decided to force the matter to arbitration, and even after the ruling on catastrophic impairment, only paid the client about a third of what was owing, Singer tells AdvocateDaily.

Saskatchewan overhauls auto injury coverage

REGINA – The Saskatchewan government is moving forward with changes to its auto injury coverage that it says will help people after a crash.

Don McMorris, minister responsible for Saskatchewan Government Insurance, says the changes will close loopholes that left some people unable to sue.

One change would allow an innocent party or family to sue for pain and suffering or bereavement damages if an impaired driver was killed while causing a collision.

Injured people would also be able to sue if they were hurt by someone fleeing from police or street racing.

The government also aims to update amounts paid for living expenses and to cover costs of special equipment such as wheelchairs.

In an interview with AdvocateDaily.com, Toronto personal injury lawyer Darryl Singer says in the grand scheme of auto insurance claims, the proposed changes are largely insignificant.

“My initial thought is that it’s legislation that has a minor impact on the everyday person,” he says. “I don’t think that these changes, even if implemented in Ontario, would help the majority of people.”

In Ontario, the family of an impaired driver killed while causing a collision cannot sue for pain and suffering or bereavement damages, says Singer, but they can claim accident benefits.

“There is a death benefit and funeral expenses that can be claimed by the family against the driver’s own insurer,” he says, noting the issue is not black and white. “They have the right to bring an accident benefits claim, but the insurance company may defend it on the basis of an exclusion due to impairment.”

Singer says, “To me, there are such a small number of cases that would fall into that category … I don’t think it would make a big difference.”

But that doesn’t mean there isn’t room for change in Ontario’s auto insurance landscape, says Singer.

“The changes that need to be made in Ontario are to reduce the statutory threshold back to where it was years ago,” he says. “In August, the government again increased the statutory deductible. We’re going in the wrong direction.”

Due to the recent changes, the deductible is now $36,540 on all awards under $122,000, says Singer.

Legislation to make the changes in Saskatchewan will be introduced this fall, but likely would not be passed until the spring after the provincial election on April 4.

– With files from AdvocateDaily.com