At Aaron Waxman and Associates, we handle serious personal injury claims. We handle and have handled many catastrophic car accident claims. We have dedicated past blog posts to the subject of proposed changes to the definition of catastrophic impairment and to the Kusnierz case, which is being heard on November 16, 2011.
Recently, a case was heard at FSCO called Mr. C. v. Coachman Insurance Company where the insured party, Mr. C. sought catastrophic impairment determination. Coachman Insurance Company denied the determination.
Mr. C. , prior to his accident, was employed as a labourer, with a good track record and overall a good life. After the accident, he was diagnosed with Major Depressive Disorder (severe), Pain Disorder Associated with Both Psychological Factors and General Medical Condition (herniated discs) and Specific Phobia (driving, passenger anxiety). His condition continued to deteriorate and he became suicidal and expressed suicidal and even homicidal wishes towards his family. He was hospitalized for his psychological problems, and shortly thereafter, overdosed on his pain medication.
Assessments had been obtained on the behalf of Mr. C. supporting a CAT designation on the basis of marked impairment. Coachman Insurance Co. did not call any witnesses to defend its case and Arbitrator J. Miller found that in the insurer assessments, the assessors failed to comment on/consider important assessments and appeared to be biased towards the insurer. The written submissions on behalf of the insurer did not present an objective picture of evidence. Further, during the proceedings, the insurer’s counsel was aggressive with its cross-examination of Mr. C.
“Mr. C. underwent a very aggressive and at times inappropriate cross-examination. Inappropriate in that, counsel for Coachman screamed some of his questions at Mr. C. with the clear intention, in my view of intimidating Mr. C. As well, counsel glared intensely while firing off questions at a very rapid pace. In addition, counsel unnecessarily and redundantly repeated questions that already had been answered. Objections to counsel’s behaviour were consistently ignored.”
Arbitrator Miller found that Coachman Insurance Co. did not have a defense of any substance in this case and he accepted the evidence of Mr. C. and found that he suffered a catastrophic impairment pursuant to 2 (1.2) (g) of the Statutory Accident Benefits Schedule (SABS). Clause 2(1.2)(g)Â provides that a catastrophic impairment includes an impairment that, in accordance with the American Medical Association, Guides to the Evaluation of Permanent Impairment, Fourth Edition, results in a class 4 (marked impairment) or class 5 (extreme impairment) due to mental or behavioural disorder.
Coachman Insurance Company and its counsel were not allowed to use bullying or intimidation as means of defending the claim. Bullying cannot be tolerated, nor should not be tolerated at FSCO.
The decision was released on October 21, 2011.
Tags: car accident claims, catastrophic cases, personal injury lawyer toronto, toronto personal injury lawyer