By
Pace Law

OTLA Intervenes against Insurance Company Appeal

April 22, 2021

The decision of an upcoming court case could have a powerful impact on the livelihood of personal injury victims’ ability to benefit access.

Alexander M. Voudris, a senior litigator with Pace Law Firm, is co-counsel with 3 other lawyers representing the Ontario Trial Lawyers Association (OTLA.)

The OTLA is intervening in the appeal by an insurance company of a License Appeal Tribunal (LAT) decision regarding payment for treatment to the victim of a motor vehicle accident which occurred in 2013.

Last March the LAT found the woman was entitled to having her chiropractic treatment costs covered by her insurance company, however, the insurance company argued that her claim should not have been heard since expenses for treatment had yet to be incurred.

OTLA counters that the LAT had the right to order payment of the treatment once it was incurred, and rejects the Insurer’s argument that the accident victim first had to pay for the treatment before the LAT could decide whether the treatment is payable. This of course is based on a practicable understanding of the legislation, at least 27 years of practice and case law, and the fact that Insurance law is consumer protection legislation.

In an article written for Legal Matters Canada, Steve Rastin, Voudouris’ co-counsel states, “…if you accept what they’re saying, it was too early for the accident victim to go to LAT until she has incurred the expense…what that would mean is that SABS is only for people who have the money to pay for the treatment now with the hope of getting reimbursed later.”

Rastin states that an accident victim submits a treatment plan to their insurance company for approval in the usual procedure. The insurance company’s stance is unjust as some treatments may cost upwards of thousands of dollars, thus unaffordable for many people in urgent need of treatment.

OTLA argues that forcing accident victims to pay up front before disputing a claim runs counter to how the system was designed, and would deny most accident victims who cannot afford to pay up-front, without any protection, without any remedy, and without any treatment.

Further updates to come.

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Phone: 1-877-236-3060
Fax: 416-236-1809

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