Leanne Zawadzki

Leanne Zawadzki

Lerners LLP

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Retroactive Attendant Care Benefits

The recent decision in Kelly v. Guarantee Company of North America, FSCO A12-006663, (August 7, 2014), considered a claim for retroactive attendant care benefits under the Statutory Accident Benefits Schedule (SABS)....more

9/8/2014 - Attendant Care Catastrophic Impairment FSCO

Incurred Treatment

A recent Appeal decision by Director’s Delegate Evans provides some guidance on the requirement that treatment be “incurred” before it is payable under the Statutory Accident Benefits Schedule, Accidents on or after November...more

9/5/2014 - Appeals Arbitration Canada Health Insurance Insurers

Lo-Papa v. Certas Direct Insurance Company and the Minor Injury Guideline

A recent decision by the Financial Services Commission of Ontario reiterates that the onus to prove entitlement to benefits and treatment outside of the Minor Injury Guideline rests with the Insured....more

7/15/2014 - Bodily Injury Canada Insureds

Injured During a Fight on a Bus – Not an “accident” for the purposes of the Statutory Accident Benefits Schedule

A recent Financial Services Commission of Ontario Appeal Decision from Director’s Delegate Evans confirms that for the purposes of the Statutory Accident Benefits Schedule, an “accident”, is defined as an incident in which...more

5/6/2014 - Bodily Injury Canada Car Accident

Simser v. Aviva.

The Appeal decision in Simser v. Aviva (Appeal P13-00004) was recently released by the Financial Services Commission of Ontario (FSCO) on January 9, 2014. The appeal concerned clause 3(7)(e) of the Statutory Accident...more

2/3/2014

Simser v. Aviva.

The Appeal decision in Simser v. Aviva (Appeal P13-00004) was recently released by the Financial Services Commission of Ontario (FSCO) on January 9, 2014. The appeal concerned clause 3(7)(e) of the Statutory Accident...more

2/3/2014 - Canada Economic Loss Doctrine FSCO Insureds Insurers

Augustin v. Unifund – Definition of “medical reason” for the purposes of the Minor Injury Guideline

In the recent Financial Services Commission of Ontario (FSCO) decision Augustin v. Unifund (FSCO A12-000452, November 13, 2013), Arbitrator Sapin discusses what is considered a “medical reason” sufficient enough for an...more

12/4/2013 - Bodily Injury Canada FSCO

Insurer Examinations - Quinones v. Unifund

The recent FSCO decision in Quinones v. Unifund, (FSCO A12-000866, August 2, 2013), discusses the obligations placed on Insurers under s. 44(5) of the Statutory Accident Benefits Schedule (“the Schedule”) with regard to...more

10/9/2013 - Arbitration FSCO Insurers Penalties

Insurer's request for Neuropsychological Assessment is reasonably necessary and fair

Two recent decisions from FSCO have found that an Insurer’s request for a neuropsychological assessment is reasonably necessary and fair. The factors to consider in making this determination include...more

9/9/2013 - Arbitration Bodily Injury Catastrophic Impairment Emotional Injury Claims FSCO Insurers

Threshold Motion

In the recent decision of Ryckman v. Pottinger, 2013 ONSC 2857 (S.C.J.), the defendant in a jury trial was successful on a threshold motion. The decision is interesting as it gives some guidance on how the threshold...more

7/11/2013 - Auto Insurance Bodily Injury Canada Health Insurance Jury Trial Threshold Motion

Duty to Defend

An interesting decision was released by Ontario Superior Court Justice B. Glass on May 31, 2013 relating to an insurer’s duty to defend....more

7/9/2013 - Canada Duty to Defend Insureds Insurers Personal Liability

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