Accident victim wins challenge to Ontario’s $3,500 minor injury cap

Posted by Ravi Gulati | Posted in Financial Planning, News of Interest | Posted on 19-01-2014

While Scarlett had soft tissue injuries, he may have had other conditions that weren’t soft tissue injuries, said FSCO arbitrator John Wilson. It wasn’t at all clear that the victim’s injuries from the accident were minor in nature.

“It makes no sense if the insurer is positioned to veto access to benefits on the basis of the delivery of a single report, in the face of credible evidence to the contrary, when the resulting delay in treatment could last for years,” Wilson wrote.

“This runs contrary to both the spirit of the accident benefit scheme and the stated purpose of the (minor injury) guideline itself.”

The key concept is the burden of proof, says personal injury lawyer Stanley Pasternak.

“The onus is not on the injured person to show the injuries fall outside the minor injury guideline,” he explains. “The onus is on the insurer to show the injuries fall inside the minor injury guideline.”

Accident victim wins challenge to Ontario’s $3,500 minor injury cap | Toronto Star.