Homeowner Insurance Claims

Making a successful claim under your home insurance policy to your insurance company can prove to be a frustrating and unduly complicated process.

Whether your home is damaged by fire, flooding, a storm, vandalism, or if you are a victim of theft, or burglary, you deserve prompt and fair service from your home insurer.  The claims process can be replete with confusing insurance policy terms, and policy interpretations advanced by your insurance company that unfairly limit or exclude your losses.  During the claims process, it is crucial that you properly document your losses, have your losses evaluated, and if necessary proceed to litigation against your insurer with a well organized file to prove your losses.

An experienced lawyer will be invaluable in the process to ensure that you are fairly compensated for your losses and that the policy is interpreted such as to advance your rights as a policyholder and a consumer.

If you require an evaluation of your home insurance or cottage insurance claim, please feel free to contact us for a confidential consultation, free of charge.

Wrongful Dismissal

With the exception of “just cause,” or an unlawful termination of the employment relationship, an employer must provide adequate notice of termination to an employee, or alternatively provide payment to the employee in lieu of notice.  The employee would be wrongfully dismissed where the employer lacked just cause to terminate the employee and did not provide sufficient notice or payment in lieu of notice.

At common law, there are numerous factors that are considered in determining the appropriate length of the notice period in the exercise of calculating the compensation that a dismissed employee is entitled to.  Since the 1960 decision of Bardal v Globe & Mail, courts have focussed on factors that include the length of a worker’s service, the age of the worker at termination, the character of the job they have lost, and availability of similar employment.  In the midst of mass terminations and layoffs in this COVID19 pandemic era, the economic instability occasioned by this crisis will certainly impact how each of the factors in assessing the length of appropriate notice will be weighed and applied.

Nursing Home Negligence

A scathing Canadian Military report, dated May 26, 2020, revealed shocking conditions in five of the worst – hit COVID-19 nursing homes in Ontario.

The report served to raise levels of awareness of substandard infection control measures and neglect that were described as borderline abusive.

Soldiers who were deployed to the nursing homes reported inexcusable conditions of cockroach infestation and other pest control issues, rotten food, residents left in soiled diapers, and cries for help that fell upon the deaf ears of nursing home staff.  Being elderly should not be seen as a license to punish our parents, grandparents and great grandparents. Our elders deserve qualify care, exemplary service and most of all our utmost respect.

When a nursing home fails to comply with its legal duty of cart, and breaches the acceptable standard of care owed towards elderly residents and causes harm to a resident, the resident and family members can seek legal recourse through the tort of negligence, and for breach of contract.  It is an unacceptable note that nursing home negligence has become a prevalent ill in Ontario.

Nursing home negligence can take various forms, which can include:

  • Neglect of a resident’s physical, medical, emotional, dietary, social or basic needs.
  • A failure to implement acceptable measures to prevent the transmission of viral or bacterial diseases.
  • A failure to take measures to detect illness and disease.
  • A failure to provide requisite medical care to its residents.
  • A failure to communicate required information to authorized family members.
  • A failure to adequately supervise staff.
  • A failure to investigate complaints made by or on behalf of a resident.

If you or a family member have suffered damages due to the negligence of a nursing home, please contact us for a confidential assessment of your case, at no charge.

 

Just Cause

It is the onus or the responsibility of the employer to demonstrate that just cause exists so as to not deprive the dismissed employee of a legal remedy.  As a general statement, to demonstrate just cause, the employee’s conduct must be considered to be sufficiently serious as to sever the employment relationship.  Where an employer raises just cause as a defence, the scope of the litigation will often focus upon the factual circumstances to determine if the employer’s account is accurate, and moreover, whether the alleged misconduct by the former employee in any event was sufficiently severe to pass the muster to justify a dismissal with just cause.

Unlawful Termination

In addition, an employer is not permitted to terminate an employee’s job for an unlawful reason.  Where an employer terminates the employment relationship on the basis of enumerated grounds in the Human Rights Code, or to punish the employee for engaging his or her rights under the Employment Standards Act, or the Occupational Health and Safety Act, the discharged employee may be entitled to be reinstated to his or her former position in addition to other remedies. 

For a free and confidential discussion of your employment related legal issue, please feel free to contact us.

Disability Insurance

Disability insurance is a type of insurance that courts have described as providing “peace of mind” to insured consumers.  Peace of mind policies are intended to reduce stress and anxiety about what can potentially happen in the future.

Disability policies can generally take on two forms:  individual policies issued directly to a policy holder, or group policies which are typically issued by an insurance company to an employer for the benefit of employees.

Disability policies can provide short-term or long-term disability coverage. Short-term disability policies usually provide coverage for up to six months before long-term disability coverage takes effect.  In the absence of a short-term disability policy, a disabled claimant may be eligible to receive Employment Insurance Sickness Benefits which provides coverage for a maximum of fifteen weeks.

Although individual policies differ, typically long-term disability policies have a graduated definition of the term “disability,” with the “own occupation test” applicable while the disabled individual is unable to perform the main duties of his or her regular job.

At the two-year juncture, the typical policy contains a graduated definition of disability which provides for monthly benefits in the event that the disabled person is unable to perform the duties of any job for which he or she is reasonably suited.  This graduated definition is coined the “any occupation” test, and is usually applicable to the age of 65, which would be the maximum termination date of benefits.

Most litigation revolves around the satisfaction of the “any occupation” definition of disability. Insurers often strictly interpret the “any occupation” test, and seemingly give less weight to “subjectively based” types of illnesses or injuries, or propose employment alternatives that are inappropriate given the circumstances of the disabled person.  These particular types of illnesses or injuries can vary from psychological illness, e.g. anxiety and/or depression, chronic pain, or fibromyalgia.

If the insurer denies your claim or terminates benefits, most policies provide for an internal appeal mechanism, and if this fails, litigation through the courts system is the usual course of action.

In negotiations for a denied disability claim, the basis for compensation would include past and future monthly benefits owed under the policy, legal fees, and potentially aggravated damages for mental distress, or punitive damages against an insurer who has engaged in unfair and sharp practices.

If your disability claim has been denied, feel free to contact us for a confidential assessment of your case, at no charge. 

Uninsured Motorist Coverage

Uninsured motorist coverage offers a layer of protection in the event that a person sustains injury due to the negligence of the owner or operator of a motor vehicle that is uninsured or is unidentified. Coverage is mandated by section 265 of the Insurance Act in the amount of $200, 000.00 which is the minimal insurance liability limits in Ontario.  With this form of coverage, your insurer essentially “steps into the shoes” of the uninsured or unidentified motorist.

By the operation of what is often coined as the “1% Rule”, in the event that an injured party can be compensated by a third party motorists policy, such as in the event of a multi – vehicle collision, Uninsured motorist coverage would not be available.

To provide procedural safeguards to protect against fraud, Uninsured motorist coverage requires the would be claimant to report the automobile accident to a police officer within 24 hours, and to provide a written statement detailing the circumstances of the accident,  and a description of the claim for compensation with supporting documents within 30 days.

Where there is policy for which to make a claim for Uninsured motorist coverage, as a last resort an injured party can advance a claim to the Ontario Government administered Motor Vehicle Accident Claim fund, which is also capped at $200, 000.00.

In addition to Uninsured motorist coverage, typically policyholders also opt for separately purchased coverage in the form of Family Endorsement Protection. Family Endorsement Protection provides coverage in excess of coverage available under from a third  – party policy of an at fault party or under the provisions of Uninsured Motorist Coverage.  Family Endorsement Protection prohibits the “stacking” of coverage by limiting available coverage to the difference between available coverage from other sources and the limits of the Family Endorsement Protection. For instance, if the injured party’s damages were assessed at $800, 000.00, but only $250, 000.00 of third – party coverage was available, the injured party would recover the difference between the two policies in the sum of $550, 000.00.

 

If you have any questions about Uninsured motorist coverage, the Motor Vehicle Accident Claim fund or the Family Endorsement Protection provisions of your policy, please feel free to contact us for a confidential consultation, at no charge.