A recent decision of an arbitrator has confirmed that chronic pain syndrome can be enough to get an accident victim out of the Minor Injury Guideline.  Under the guideline accident victims are entitled to significantly reduced medical and rehabilitation benefits. In Arruda v. Western Assurance Company the insured accident victim suffered from soft tissue injuries and psychological impairments arising from her physical injuries. After Ms. Arruda's medical and rehabilitation benefits were exhausted under the Minor Injury Guidline she applied for further treatment which was denied. Ms. Arruda's injuries had initially been described as muscle and ligament strains and sprains.  But twenty months post-accident [...]

A decision of the Ontario Superior Court has reinforced that automobile insurers cannot take unreasonable settlement positions in lawsuits.  If they do, they may face cost consequences at the end of the day. After a jury verdict was handed down in a chronic pain case, Justice Howden was asked to award costs to the successful plaintiiff.  His honour applied his experience on the bench to arrive at a global assessment, looking at more than just the bill of costs submitted by the plaintiff.  In the end, Justice Howden mposed a penalty on the insurer defendant based upon the criteria set out [...]

Court Concludes that Orthopaedic Insurer Examinations Have Little Value in Chronic Pain Cases One of the more frustrating aspects of practicing in accident benefits law that that insurance companies repeatedly send claimants who have soft tissue, chronic pain injuries to orthopedic surgeons for independent medical examinations to determine their eligibility for certain benefits or the reasonableness of treatment plans. They are requested to perform these assessments even though they are typically outside their area of expertise. Way more often than not, the assessment invariably finds “no objective evidence on ongoing impairment”, following which, the insurer denies all benefits.  In a recent [...]