When a person becomes a victim of a motor vehicle accident, he or she enters a strange, confusing world governed by complex statutes and regulations. These include the Insurance Act of Ontario, which governs and regulates the victim's entitlement to ongoing statutory accident benefits (SABs) from his or her own insurance company, as well as many of the court procedures to be followed in claiming against the at-fault parties responsible for the motor vehicle collision.

• ACCIDENT BENEFITS

1. The insurance company insuring the vehicle that you or a family member or significant other own, or are otherwise insured under, or;
2. The insurance company of the vehicle in which you were a passenger, or;
3. The insurance company insuring the other vehicle involved in the accident.

Currently, you may qualify for income replacement benefits (IRBs) equal to 80% of your net income to a maximum of $400.00 per week; a non-earner benefit; or a caregiver benefit if you are the primary caregiver for a person in need of care. You may also be entitled to medical and rehabilitation benefits of up to $100,000.00 for up to 10 years if you suffer a non-catastrophic (CAT) injury, or $1,000,000.00 over your lifetime if you suffer a CAT injury. There is also provision for attendant care benefits for your personal care, at $3,000.00 per month for up to 2 years, and in case of a CAT injury, at $6,000.00 per month to a maximum of $1,000,000.00 over your lifetime. Other benefits may also be payable to you.

The Statutory Accident Benefits Schedule (SABS) under the Insurance Act provides access to significant statutory benefits, regardless of fault, for those injured in motor vehicle accidents, including medical rehabilitation and attendant care benefits, weekly income benefits, caregiver benefits, reimbursement for housekeeping and home maintenance, and in the event of death, death and funeral benefits payable under the insurance policy.

• LAWSUIT AGAINST THE AT-FAULT DRIVER

Your lawsuit claims may encompass recovery for pain and suffering; loss of enjoyment of life; loss of income and loss of competitive advantage; housekeeping and home maintenance expenses not covered under your SABS, together with health care expenses not covered under your SABS.

To claim for pain and suffering, you must have suffered a permanent and serious impairment of an important physical, mental or psychological function, or permanent serious disfigurement such as amputation, paralysis, or scarring. This is part of the "threshold" test, which is mandated by the Insurance Act in favor of your insurance company.

You may also claim for loss of income that is not subject to the above threshold test or deductible. Accordingly, you may claim 80% of your after-tax income loss up to the date of settlement or trial, which you have not received under the SABS. In case of continued inability to work, your future or prospective income losses may be claimed at 100% of your gross income loss, less any monies you may receive under the SABS, long term disability, or Canada Pension.

Gillis Zago has over 100 years of experience working with family physicians, medical specialists and other health care professionals in properly documenting the extent of injuries, and the resulting degree of disability and impairment suffered by you and/or your loved ones. We work closely with your doctors, and with rehabilitation specialists, occupational therapists and others in order to provide the most comprehensive solutions to the needs and concerns that you or your loved ones may have.

We work hand-in-hand with you, the client, to advance your case, and to keep you well informed as we proceed.

Most cases involving serious personal injury settle before coming to trial. We have access to, and good relationships with, the many private mediators whose role it is to conduct mediations with a view to an early settlement. We have a reputation for strong and effective negotiation.

If, however, your case does not settle via mediation, we are also experienced as trial counsel to effectively present your case before a Judge and Jury in Court.

• LONG TERM DISABILITY (LTD) COVERAGE

Many employers provide significant benefits under short and long term disability insurance coverage. Many such insurance policies have dual definitions of disability. Most policies have a disability definition for a period of two years that covers inability to work at the same employment position or occupation pursued on the date of loss. After the first two years, a secondary definition is engaged with the intent to stop further benefits.  The definition of disability after two years requires that there be an inability to work at any employment for which the insured is reasonably qualified by reason of education, experience and other capabilities. Each claim will be governed by the insurance policy that applies to said claim.

We are well experienced in engaging professionals and other specialists to determine the vocational, physical and psychological capabilities of our clients, and in presenting cases for ongoing disability benefits. We are frequently able to achieve an immediate lump sum settlement with regard to all future payments available under the LTD insurance policy.

• SLIPS & FALLS

An impressive number of serious injuries can often occur as a result of what initially appears to be a simple slip and fall, whether outdoors in icy conditions or on unkempt sidewalks, or during other unexpected situations, or inside a shopping mall, grocery store or other interior location.

Typical injuries involve fractures to the lower extremities, including to the ankle joint or patella (or knee cap), or to the upper extremities, including arms or wrists, or worse - closed head injuries resulting in brain impairments. These cases frequently are decided within the context of the Occupiers Liability Act.

The relevant section of the Act provides for the following:

The Law is very clear in obliging owners and occupiers of premises to keep sidewalks, steps and other areas of entry clear of snow, ice or other hazard. As Canadians, we know that our winters can be harsh, and that we must take care for our own safety. At the same time, we are entitled to expect reasonably prompt and thorough snow removal, and application of salt, sand or other abrasive within a reasonable time following a significant snowfall or freeze.

The Courts have also imposed a high standard of care on owners and occupiers of commercial and public buildings in the case of incidents occurring in an interior setting.

• PRODUCT LIABILITY MATTERS

Serious personal injury can occur through the use of faulty consumer goods, elevators, amusement rides and devices, unsafe watercraft and exercise equipment. At Gillis Zago we have access to design and other engineers and specialists to review the products or devices that have caused your injury.

Designers, manufacturers and sellers of goods all have obligations to the ultimate consumer, whether directly as a matter of contract, via tort or negligence liability, or under the Sale of Goods Act.

• MEDICAL/DENTAL MALPRACTICE

During the course of medical treatment, serious injury, and death, can and frequently do occur in unexpected circumstances. In many cases, the involved doctors, hospitals, nurses and other staff have done their best, and are as unprepared for, and shocked by, the patient outcome as are the victim and his or her family. Nevertheless, the question always remains: did the treatment provided by the health care professionals meet the appropriate and reasonable standard of care and competency that the patient was entitled to? The standard of care required of a medical practitioner has been long established, and is stated by Lord Hewart C.J. in R. v. Batement (1925), 41 T.L.R. 557 at p.559:

There is also a second question: did professional negligence cause the injury or death? This too requires the professional opinion of someone other than a lawyer, who cannot tell you whether or not there has been professional negligence in the course of treatment and care.

Gillis Zago has a number of consulting physicians, specialists and other health care professionals on retainer who can be relied upon to provide clear and helpful analysis and opinions on these two basic and critical issues. Our comprehensive initial consultation in this area enables their investigations to proceed.

You have limited time to commence proceedings against a health care professional - as little as one year from the date of treatment. Even shorter limitation periods may apply in special circumstances. Legislation regarding limitation periods has undergone significant statutory changes, and it is crucial that you retain a lawyer at the earliest opportunity in order to avoid your case from becoming statute-barred because of lack of time.

Our initial consultation is provided on a no fees basis in order to facilitate important and necessary investigations, and to commence proceedings. Please contact us for an appointment.