How Do Non-Salary Payments Impact the Calculation of an IRB?

A close look at the impact that Employment Insurance (“EI”) Benefits, Canada Pension Plan (“CPP”) Disability Benefits, Pension Benefits and Severance Pay have on the calculation of Income Replacement Benefits (“IRBs”) under both the ‘Old’ and ‘New’ (Sept. 1, 2010) SABS. More...

The Impact of Self-Employed Employment Insurance Benefits on the Calculation of IRBs

Employment Insurance (“EI”) benefits for all! Well, not quite, but there are now a variety of different ways in which a self-employed individual can receive Employment Insurance benefits. In some cases, these benefits need to be factored into the quantification of a claimant’s IRB. For more on this subject, see our Fall 2011 ForensicFOCUS newsletter, available in our Virtual Office website.

The Importance of Treating File Notes and Reports as Potential Evidence

On November 22, 2010, the Financial Services Commission of Ontario (“FSCO”) rendered their decision in the matter of Dawn Smith and Economical Insurance Company (“Economical”) (FSCO A09-001477). In this decision, Arbitrator Lee relied almost completely on the credibility of the witnesses, rather than the submitted reports, which he determined could not be relied on. For a summary of this decision, see our Winter 2011 ForensicFOCUS newsletter, available in our Virtual Office website.

If the IRB quantum is $0, is the claimant “entitled” to an IRB?

An interesting question and one that was addressed by FSCO. For a summary of this issue and more, see our Fall 2008 ForensicFocus newsletter, available in our Virtual Office website.

What adjustments are required if an accident benefit claimant turns 65 either before or after the date of their disability?

For details of the adjustments required for claims submitted either before or after a claimant's 65th birthday, and an indication of how these adjustments are administered in H&A's online IRB calculator, see our Fall 2008 ForensicFocus newsletter, available in our Virtual Office website.

Is Your Insured's Dependent Really Dependent?

It is all or nothing when the issue under the SABS is priority: was the claimant principally financially dependent on support for your insured or not? Determining whether or not a person is principally dependent for financial support on another person is a forensic accounting process - a precise exercise using somewhat imprecise numbers. Needless to say, the outcome of such a process determines which insurer will bear the entire cost of the dependent person's claim under the SABS. More...

Don't Let a 'Special Award' Happen to You!

“Special Awards” are made when “an insurer has unreasonably withheld or delayed payments”. In 2008, the FSCO rendered their decision in the matter of James Johnston and AXA Insurance (Canada) , followed by their decision in the matter of Connie Lisowecki and Dominion of Canada General Insurance Company. The one thing these two decisions have in common is the Arbitrator’s findings that the Applicants shall each receive a “Special Award” as a result of their insurer’s approach to the quantification of the weekly income replacement benefits (“IRBs”) payable to them as a result of their motor vehicle accidents. More...