Nov 26, 2019 in News Accident Benefits Claims

Accident Benefits Claims: Decade-long Insurance Dispute Highlights Imbalance Between Plaintiffs, Insurers

More than 11 years ago, in March 2008, Thomas Waldock was hit by a car while helping a stranded motorist on the side of an Ontario road. Waldock suffered the kind of serious injuries that are familiar to any car accident lawyer in the province, injuries that his legal team expected to become more severe over time.

Unfortunately, when Waldock applied for statutory accident benefits, his insurer, State Farm, disputed whether his injuries were catastrophic. What followed was more than a decade of legal skirmishes that prevented Waldock from accessing the benefits he was owed, according to a recent article in Law Times.

Waldock v. State Farm Mutual Automobile Insurance Company, which was finally decided in Waldock’s favour this October, is a classic example of a powerful organization leveraging its financial and legal resources to wear down plaintiffs. The Financial Services Commission of Ontario (FSCO) arbitrator who was assigned the case agreed that Waldock’s injuries were catastrophic. State Farm appealed, and the case was reassigned to the arbitrator, who awarded benefits, expenses, and a special award in 2015. State Farm appealed this decision as well and launched a variety of motions. Eventually, Waldock’s legal team launched a judicial review application, which was heard by the Superior Court in October 2016. The arbitrator released another decision the next year to clarify his expenses decision, which State Farm successfully appealed to the Director’s Delegate. Waldock’s team once again applied for judicial review. The case eventually appeared before a Divisional Court panel who finally ruled that Waldock should receive accident benefits for attendant care and housekeeping, plus the special award. State Farm could still appeal the decision.

Was that difficult to follow? Imagine the pain and suffering of the injury victim as the case wound its way from the FSCO to the Director’s Delegate, the Superior Court, and the Divisional Court panel. In the time it took the courts to reach their decision, the province’s auto insurance system and insurance dispute resolution process have undergone fundamental changes. The FSCO no longer even presides over insurance disputes; that responsibility now lies with the Licence Appeal Tribunal (LAT).

Unfortunately, State Farm’s war-of-attrition-style approach to the Waldock case was not an outlier. Personal injury lawyers in Ontario often face insurance companies and other influential organizations that aim to wear down less-powerful opponents. In the medical malpractice field, for example, the Canadian Medical Protective Association (CMPA) is known to apply scorched earth tactics in defence of physicians. This strategy puts Ontario’s injury victims at risk.

If you’ve been injured in a car accident, contact Neinstein Personal Injury Lawyers today to schedule a free, no-obligation consultation with an experienced car accident lawyer. Our team can help you file your insurance claim and represent you in any legal disputes that might arise.

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