Valuing Long-Term Disability (LTD) Claims

Personal injury lawyers in Mississauga, Brampton, or Burlington, field lots of questions from prospective clients, one of which is “How much do you estimate my long-term disability case is worth?” Since every LTD case is complex and different, it is very difficult to answer this question. However, most of the lawyers refer to a host of things to come up with an approximation.

Factors to Consider

Whenever a lawyer is evaluating a claim to determine what it is worth, there are a number of factors that must be considered such as:

  • all source maximum deduction in effect?
  • any bad faith on behalf of the insurer when handling the claim
  • any surveillance conducted by insurance company?
  • arrears or back payments owed to the LTD insurance carrier
  • claimant’s age
  • claimant’s education, training, and work level experience
  • duration of payment on the policy benefits
  • employment potential of claimant
  • insurance company doctor’s evaluation of injuries and return-to-work prognosis
  • is claimant fluent in English or French?
  • is insurer entitled to any “set-offs” (Canada Pension Plan, Workplace Safety and Insurance Board)?
  • nature and extent of injuries
  • value of monthly benefit
  • your doctor’s prognosis on returning to work

In large part, the long-term disability claim’s value will be based on the above and how any questions relevant to that are answered.  Plus, that the insurance adjuster will look at any unique factors relative to your personal injury case.

Unlike other accident and injury claims, long-term disability claims are commonly valued by using mathematical equations.  The formula used for determining the LTD benefit’s value is calculated as follows:

value of the LTD benefit – any offsets / number of months of arrears and

future benefits owing = insurance company’s maximum exposure owed

For instance, in a motor vehicle accident case, the compensation for a plaintiff’s pain and suffering is based subjectively on precedents set in past cases.  There are different Damages categories for personal injury claims in Brampton, Burlington, or Mississauga which commonly include:

  • attendant care
  • family law act (e.g. loss of care and companionship)
  • housekeeping
  • modified home or vehicle
  • out of pocket expense
  • pain and suffering
  • past and future care cost
  • past and future income loss

As you can clearly see, there are a number of damage categories that could potentially be awarded in a motor vehicle accident case on the tort end.  However, when it comes to long-term disability claims, many of those damage categories don’t exist.  Basically, these are defined as “contract” claims.  In other words, if there is no insurance contract, there cannot be a claim.  They are based on what’s contained within the wording inside your auto insurance policy.

For more clarification and guidance throughout your LTD case, you should consult with a knowledgeable personal injury lawyer who specializes in the type of accident you experienced and the injuries you’ve sustained.  Remember, your lawyer may be the only assurance of getting the compensation you deserve and ensuring that your rights are protected.

We proudly serve the residents in the Mississauga, Brampton and Burlington areas. If you want a personal injury lawyer that represents your best interests, we’d love to review your case and give a free consultation. Contact us today!

Beware! The Insurance Companies can use Social Media against You

It’s not uncommon to hear insurance companies advertise how they’re the best because they are always there for their policyholders when they need them.  While they may be there to defend a claim, they will quickly become your opponent in a personal injury lawsuit in Brampton, Burlington, or Mississauga.  The reality is that they care about their own interests only – not yours.  This is something that the plaintiff should always keep in mind whenever they are posting their goings-on on social media sites.

Hiring private investigators

The truth of the matter is that a defendant’s insurance company will hire private eyes or investigators to survey the plaintiff’s activities.  Basically, they want to catch you doing something that goes against your injured condition in order to invalidate your claim and not settle with you fair and reasonably.  This is not to say that some plaintiff’s don’t “overstate” the seriousness of their injuries.  However, the insurance companies treat every plaintiff in similar fashion, whether they have misrepresented their injuries or not.

As an example of this, let’s say you have filed a personal injury claim after you were injured in a motor vehicle accident in Brampton, Burlington, or Mississauga.  According to your claim, your injuries were serious enough that you were unable to work.  Then the defendant’s insurance company’s investigators take photos of you participating in an activity that your injuries have supposedly rendered you incapable of doing.  Should this evidence be presented during litigation, it would undermine your credibility.

Use of social media scrutinized

Consequently, you’re not going to be awarded the settlement you had hoped for.  In recent years, investigators have started perusing plaintiff’s profiles on different social media sites such as Facebook and Twitter for this reason.  Today, it’s become common practice to apply for access to a person’s photos and posted content on social media sites in personal injury cases held in Brampton.  So what is the lesson that accident victims should learn from this?

Whenever you are involved in a personal injury lawsuit, you have to realize that whatever you post on social media websites could come back to haunt you during legal proceedings.  In addition to this not being used as evidence against you, you should be cautious about any statements you make relative to the photos you post on these sites.  Otherwise, you will jeopardize your case proceeding in your favor. Thus, it is best to shun social media as far as possible because you don’t really know what could go against you in court

This easiest way to keep your case uncomplicated and your personal injury lawyer working in your favor is to ensure that your social media usage doesn’t complicate matters for you.  You can always resume your activities once your case has been settled in court or negotiations.  Ultimately, the smartest way for you to protect your own interests in is to be honest about your physical impairments and demonstrate your truthfulness in your activities.

We proudly serve the residents in the Mississauga, Brampton and Burlington areas. If you want a personal injury lawyer that represents your best interests, we’d love to review your case and give a free consultation. Contact us today!

A Guide to the upcoming Changes to the SABS

Auto insurance throughout Ontario Province will see some major changes and revisions to the no-fault or Statutory Accident Benefits Schedule (SABS) as of June 1st, 2016.  So if you live in the cities of Brampton, Burlington, or Mississauga, these changes will apply to you.  On August 31st of last year, it was announced that the newly revised SABS will apply to every motorist in the Province when they renew their auto insurance policy after the implementation date of June 1st.

So what does this mean for driver’s throughout the Province and how will they be affected by these revisions? It’s safe to say that these changes and revisions benefit the insurance companies more than those who need these benefits.  Thus, if you have been injured and were receiving these benefits, it might affect your life and treatment. Consequently, it puts additional pressure on the insured to ensure that they have ample coverage.  Here are the more important changes to be aware of.

First and foremost, the benefits afforded by the SABS will be drastically reduced with one of the more severe cuts being to the non-earner benefit.  Non-earners were originally awarded this benefit after a 6-month wait but could continue receiving it provided they could demonstrate an ongoing inability to live a normal life.  Although the waiting period was reduced to 4 weeks, recipients will only be paid this benefit for a maximum of 24 months.

Secondly, statutory accident benefits for attendant, medical, and rehabilitative care have been reduced as well.  If you were injured in an accident and your injuries are classified as non-catastrophic, those three care benefits are combined into one single benefit of no more than $65,000.  Originally, individuals received up to $50,000 for medical and rehabilitative care plus up to $36,000 for attendant care.  So the maximum benefit for all three has been reduced from $86,000 to $65,000 – a total of $21,000!

Furthermore, the maximum time period for receiving these benefits has been cut by 50% from 10 years to 5.  For catastrophically injured individuals, the total attendant, medical, and rehabilitative care benefits was divided into 2 separate funds of $1 million each (a total of $2 million).  With the current changes to the Statutory Accident Benefits Schedule, the total has been reduced by 50% to $1 million payable in a single combined benefit.  For individuals who truly need these benefits, there is a great deal of concern.

There is also a second optional medical and rehabilitative care benefit of $100,000 and a $72,000 attendant care benefit (also optional).  Both of these have been combined into a single benefit that pays a maximum of $130,000 (a $42,000 reduction).  Basically, insurance companies are going to have more control over the SABS and the benefit amounts that get paid out.  More importantly, they will have additional power when it comes to denying necessary products and services whereas your healthcare provider can approve them under the current system without insurance companies interfering.

We proudly serve the residents in the Mississauga, Brampton and Burlington areas. If you want a personal injury lawyer that represents your best interests, we’d love to review your case and give a free consultation. Contact us today!

A Comparison of Compensatory and Punitive Damages

In personal injury lawsuits, the injured individual (plaintiff) has to prove that their injuries were caused by another person (defendant) due to their careless, negligent, or reckless behavior.  Whether the lawsuit takes place in Brampton, Burlington, or Mississauga, or anywhere else in Ontario Province, the plaintiff may be awarded damages in the form of monetary compensation for any losses that resulted from the defendant’s behavior.  There are two types of damages that are normally awarded in a personal injury case. (more…)

Why Insurance Companies operate in Their best Interests, not Yours

Let’s be realistic for a moment.  If the insurance companies paid the maximum amount of compensation on every personal injury claim that was filed against them, they would probably run out of money.  Furthermore, there wouldn’t be much of a need for personal injury lawyers in Brampton, Burlington, or Mississauga.  If the insurance company pays your claim up front without any argument, why would you need a lawyer? But then again, this is the real world, not some fantasy world.

While the insurance companies try to make us believe (by virtue of their advertising claims) that they are always on our side, this simply isn’t the case because at the end of the month, all they are concerned with is the percentage of increase to the bottom line.  So it’s safe to say that insurance companies typically deny claims for financial reasons.  They don’t want to believe the severity of your disabilities or injuries because they don’t want your claim to adversely impact their bottom line.

Common reasons for claim denial

Over and above the financial implications discussed above, one of the more common reasons that insurance companies deny claims or refuse to believe you may be due to independent medical examinations or reviews.  While these exams or reviews can be conducted on an in-person basis, insurers have been known to take medical documents and reviews that they have received and forward them to their doctors for evaluation.  This is typically done without ever talking to the injury victim or plaintiff.

Regardless of how ridiculous or unfair this practice appears to be, it is a common occurrence throughout the industry in today’s personal injury world.  The explanation that personal injury lawyers in Brampton, Burlington, or Mississauga get whenever they question this practice is that it is quicker and much more cost-effective than conducting an in-person medical exam.  However, when so much may be riding on that medical exam or review, this practice is nothing short of inappropriate.

There are also times that insurance companies deny injury claims because additional medical documentation and evidence is required or forms aren’t completed or filled out correctly.  In cases such as those, all a personal injury lawyer usually has to do is write a few letters on your behalf and make sure that all the “I’s” are dotted and “T’s” have been crossed.  In other cases, miscommunication between the insurance company and the plaintiff is the main reason for a denial. Thus, ensure that it does not happen in your case.

Every personal injury lawyer should be cautiously optimistic regarding an injury victim’s claim, just as you should be.  After all, you never want to take anything for granted.  By retaining the services of an experienced Brampton, Burlington, or Mississauga personal injury lawyer, you stand a better chance of a getting a fair and reasonable settlement in court or at the negotiating table.

We proudly serve the residents in the Mississauga, Brampton and Burlington areas. If you want a personal injury lawyer that represents your best interests, we’d love to review your case and give a free consultation. Contact us today!

The Role of Your Physician in a Long-Term Disability Claim

There is a great deal of dissension currently going on in Ontario Province between physicians and the provincial government.  While the two parties have not had a legal contract in force for quite a while now, there has been a great deal of disagreement involving terms.  The government has cut physician fees and eliminated some billing codes.  Consequently, this has impacted thousands of doctors.  Unfortunately, this has caused some physicians to close clinics, leave unprofitable health centers, and scale back their availability.

 

Suffice it to say, this has impacted the role of the physician that they play in long-term disability claims and other personal injury claims.  A personal injury lawyer in Brampton will tell you that when the day is done, and your claim has been filed, that your physician plays the most important role in the legal process.  The best part is about seeing a doctor no matter where you live in Canada. It costs you nothing unlike what some people in the US experience whenever they have to see theirs.

 

From a legal standpoint, the injury victim or plaintiff is in control of building their claim based on the medical evidence they have.  It’s important to realize medical evidence is the foundation of long-term disability and personal injury claims.  Without out, there is no claim and no compensation for damages.  You can’t just testify that you’re hurt or that you were seriously injured.  You have to prove that and you have to prove it as convincingly as possible.  Medical evidence is the convincing proof that personal injury lawyers must rely on in order to successfully negotiate a settlement.

 

Your physician is the only person who can provide this essential evidence.  Their documentation will contain a wide range of critical information where this is concerned such as:

 

 

Your personal injury lawyer will rely heavily on the information that your physician provides.  Most importantly, the information provided in your medical documents the best insight into your complaints, your injuries, your pain, and your quality of life.  An experienced injury lawyer knows the value of a physician’s medical documentation.  They will base the claim on the evidence gathered, witness accounts and your medical reports. However, the most important aspect of the claim’s process is their role in the context of your treatment and recovery.

Needless to say, finding the right physician to care for you from the initial diagnosis and treatment stage up to an including your long-term disability care.  So it is important that for you to ensure that you assist your physician as much as possible and provide any information that is asked of you when you are under their care. They are the only ones who will be able to help you get the required compensation and justice.

We proudly serve the residents in the Mississauga, Brampton and Burlington areas. If you want a personal injury lawyer that represents your best interests, we’d love to review your case and give a free consultation. Contact us today!

Reasons to Work With a Personal Injury Lawyer

Most individuals never imagine the need to hire a Brampton injury lawyer until they are involved in an accident that was due to someone’s carelessness. However, there are a number of reasons why you or your family members should understand the importance of hiring this type of lawyer.  This is especially true if you have sustained injuries that leave you incapacitated and your family is financially devastated because you are no longer able to contribute.

When you have sustained injuries in an accident, what you do or a family member does in the first few hours is crucial, and not just for your health and well-being.  The sooner you seek legal representation from and experienced injury lawyer, the better your chances of receiving a fair and equitable settlement after your claim is filed.  You could be entitled to compensation and a personal injury lawyer can ensure that your rights to that compensation are protected in court and at the negotiating table.

It is imperative that evidence supporting your claim is gathered immediately or as soon as possible.  This will help you and your lawyer to build a strong foundation for your personal injury claim.  It will also help to ensure that you are given proper medical care and attention from the time you are treated until you have completely recovered.  This also pertains to maximizing your accident benefits (if applicable) and hopefully settling your claim out of court.

One of the more important reasons for hiring an expert injury lawyer is because they are experienced at going up against the big insurance companies and their lawyers.  The right personal injury lawyer will not let the insurer or their lawyer intimidate them in court or at the negotiating table.  Furthermore, they will be able to navigate through an inundating mass of complicate forms and paperwork that would normally intimidate and overwhelm the average individual.

Many insurers are well-known for having complex, hard to understand limitations that can affect the amount of compensation that you will be allowed.  There are most likely other provisions that do not favor an injury victim such as exclusions that may decrease your settlement amount or strict deadlines that must be adhered to.  Your lawyer can assist in getting all forms and paperwork completed accurately and quickly so that your best interests will be protected when progressing with your claim.

Most importantly, a Brampton injury lawyer and a compassionate support team can go a long way to ensuring that your stress and worry are alleviated.  In so doing, you can focus on what is truly important – recovering from your injuries and trying to restore the quality of life you were experiencing prior to sustaining your injuries.

With plenty of lawyers in Brampton and greater Toronto area, you won’t find it difficult to work with some of the best lawyers that have a history of successful cases.

We proudly serve the residents in the Mississauga, Brampton and Burlington areas. If you want a personal injury lawyer that represents your best interests, we’d love to review your case and give a free consultation. Contact us today!

Legal Assistance for Victims of Catastrophic Injuries

No one ever leaves there thinking they will sustain catastrophic injuries in a vehicular accident and leave their families financially devastated.  What would you do if this happened to you? Would your family know how to conduct its daily affairs and be financially secure if you were ever incapacitated? It’s never easy talking about this subject.  But the reality is that catastrophic injuries happen so you and your family they need to know what to do and what to expect.

Statistics to be concerned with

The most common catastrophic injury claims that an injury lawyer in Mississauga and his or her legal team represent in today’s world are spinal cord and traumatic brain injuries.

According to government statistics, Ontario Province records 600 new cases of spinal cord injuries on an annual basis.  That’s more than 1 every day of the year.  Current estimates show that over 33,000 people in the Province are living with this type of injury as this content is being written.

Furthermore, 1 out of every 200 Canadians suffers a traumatic brain injury each year, 18,000 of which will happen in Ontario Province.  In addition to this, 35 individuals are admitted to hospitals on a daily basis and it has been estimated that 5,000 children will sustain catastrophic injuries this year.  Finally, 50% of all traumatic brain injuries are attributed to motor vehicle accidents (30%) and sports (20%).

Common Catastrophic Injury Claims

A personal injury lawyer and their legal teams can increase your chances of recovering a much better settlement for your catastrophic injury damages than what you would experience on your own.  These types of injuries usually include:

 

  • amputation and permanent disfigurement
  • back, spinal cord, and vertebrae
  • broken bones and fractures
  • burns and scarring
  • fatal accidents and wrongful death
  • injuries to children and infants
  • paralysis injuries (paraplegic, quadriplegic)
  • traumatic brain

 

Hiring a personal injury lawyer is always recommended under these circumstances.  It is the only way to ensure that your rights to compensation will be protected in Mississauga.  Plus, the last thing you or your family members need is the stress of trying to navigate the legal process in these types of cases.

The Need for Experienced Legal Representation

In the field of personal injury law, catastrophic injury cases can be extremely complex and time-consuming.  Therefore, the victims of these injuries will have to rely on the experience and expertise of a personal injury lawyer who specializes in these types of claims.  If a personal injury claim cannot be settled out of court, it will have to be tried in front of a judge and jury – and that could take years before you or your family will ever see any compensation for damages.  Fortunately, more than 90% of Ontario personal injury claims are settled without ever going to trial.  However, it is important that your legal counsel is experienced.

We proudly serve the residents in the Mississauga, Brampton and Burlington areas. If you want a personal injury lawyer that represents your best interests, we’d love to review your case and give a free consultation. Contact us today!

How are Personal Injury Claims evaluated by Insurance Companies?

One of the more intricate aspects of personal injury law is the way in which insurance companies evaluate a plaintiff’s claim for benefits or compensation.  You have to ask yourself how insurers can establish an arbitrary amount on a person’s lost wages, their pain and suffering, and most importantly, their quality of life.  This seems like such a subjective task and yet your injury lawyer and team of legal assistants are confronted by this dilemma on an ongoing basis.

 

It’s important to understand that personal injury claims are not rolled up as one neat and tidy package.  They are more like a melting pot of separate components, yet each one is critical to the outcome of a claim for benefits or damages.  Of particular note is the concept of pain and suffering.  Unlike personal injury claims in the US, the Ontario Provincial Government has established a cap for the amount of damages that can be awarded in these types of cases.

 

In Canada, pain and suffering damages are capped around $340,000 and are awarded to individuals who have sustained injuries in an accident and:

 

  • are incapacitated and can no longer function
  • had an arm or leg amputated
  • have nightmares about their accident or injuries
  • suffer with anxiety and depression
  • suffered a spinal cord or traumatic brain injury
  • take prescription painkillers to ease their suffering

 

The process of evaluating a personal injury claim in Brampton is usually predicated by adding up the all of the damages and losses that apply along with the amount of out-of-pocket costs and legal fees.  At that point, the insurance company will quantify these damages in order to establish a settlement amount.  Naturally, there are going to be variables that must be considered such as:

 

  • causation
  • contributory negligence
  • credibility
  • credibility of the physician
  • liability
  • life expectancy
  • pre-existing condition
  • previous medical conditions

 

So as you can clearly see, these personal injury claims can be extremely complex and require the expertise of an experienced personal injury lawyer and their legal teams.  It’s important to understand how the assessment of damages transpires in these types of cases.  First and foremost, the intention of compensatory damages is to make the injury victim and his or her family whole from a financial perspective.

 

Furthermore, the quantification of damages will range from relatively easy to extremely complex or difficult.  Damages such as attendant care, home maintenance and housekeeping services, lost income, medical expenses, and property loss are easy to quantify.  Conversely, placing a dollar amount of emotional distress or pain and suffering is far more complicated.  Taking all of the above into consideration, the importance of having the support of an experienced injury lawyer and their legal teams cannot be overstated in Brampton. Thus, start looking today or give a call to the most experienced lawyers in the city and let them handle the case. They will be able to draft a strong case and help you win.

We proudly serve the residents in the Mississauga, Brampton and Burlington areas. If you want a personal injury lawyer that represents your best interests, we’d love to review your case and give a free consultation. Contact us today!

Assessing Damages in a Personal Injury Claim – Part II

The ensuing content will provide information regarding family member claims and how a plaintiff’s actions or in actions can have an impact on their personal injury claim.  While 90% of these cases usually settle out of court, it is still advisable to hire the services of an experienced personal injury lawyer in Burlington and their team of legal assistants to represent you until a settlement is reached. The fact is that without an experienced lawyer an out of court settlement will never give you maximum compensation as the insurance company will low ball you in settling for less.

Family Member Claims

Pursuant to the Family Law Act (FLA) of Ontario Province, a family member is allowed to sue for any financial losses associated with the care, companionship, and guidance that they have suffered due to the plaintiff’s injuries.  Eligible family members of the plaintiff include:

 

      • brothers and sisters
      • grandchildren
      • grandparents
      • parents and children
      • spouses

According to the FLA, the following types of claims are recoverable in these types of personal injury cases:

    • Actual expenses that have been incurred for the injured or deceased individual
    • Compensation for the loss of care, companionship, and guidance that the claimant expected to receive had the person not been injured or passed away
    • Monetary reimbursement for the injured or deceased individual’s lost income
    • Reasonable allowance for lost income or the value of housekeeping, nursing, and other services
    • Reasonable travel expense reimbursement for those eligible family members who visit the injured individual while undergoing treatment and/or recovery
    • Reasonably incurred funeral expenses

While this will give you an idea of what the family members of the deceased or injured plaintiff may be able to claim, it is recommended that you rely on the experience and expertise of a personal injury lawyer and their team of legal assistants.

Impact of a Plaintiff’s Actions or In actions

In Ontario Province, there are some cases where the injury victim’s or plaintiff’s actions have played a role in causing or contributing to the accident.  Furthermore, there are also cases where their in actions after sustaining their injuries could diminish the size of the damage award in their case.  In this case, the term “inaction” refers to not getting proper medical care or treatment.

If the plaintiff has not taken reasonable precautions for their safety or their negligence contributes to their losses, this is known as “contributory negligence” and will reduce their claim for damages.  Some examples of court-imposed reductions include:

 

    • Alcohol or drug impairment – contributory negligence of 25% to 45%
    • Failure to wear helmets while riding bikes or motorcycles – contributory negligence of 10% to 15%
    • Failure to wear seat belts in vehicles – contributory negligence of 15% to 25%

Keep in mind that an injury lawyer in Burlington will not only help you receive a higher settlement in claim than what you would on your own, they will ensure that your rights to that compensation are protected during the legal process.

We proudly serve the residents in the Mississauga, Brampton and Burlington areas. If you want a personal injury lawyer that represents your best interests, we’d love to review your case and give a free consultation. Contact us today!