Success Stories

College Student Wins Landmark Case Against Section B Insurer

Our client was an 18 year-old university student. She was injured in a car accident and was receiving ongoing physiotherapy, which helped to control her chronic pain. Without the physiotherapy her chronic pain would worsen to the point where she could not study for exams or concentrate in classes. Her Section B insurance company cut-off payment for her physiotherapy, citing two reasons: First, they cited the wording in the insurance policy that said they only have to pay for treatment for 4-years from the date of the accident, and they had reached the 4-year limit. Second, they said it was not reasonable to pay for physiotherapy if the goal was not to cure her pain. We sued the insurance company for wrongful denial of benefits and the case went to trial. At trial the judge agreed with us that the insurance company had to continue paying for benefits beyond the 4-years and that it was reasonable for them to keep paying for benefits, when it could be shown the treatment was necessary to enable the young woman to be successful at university. The insurance company appealed this case to the higher court, but we won at the Appeal as well. This case was a major victory and changed how insurance companies approach payment of rehabilitation benefits.

Court of Appeal allows Bad Faith Claim to Proceed Against Insurance Adjuster

We represented a man who was denied Section B benefits. The insurer began payment of benefits, but later cut-off payment of benefits. Insurers have a duty to administer Section B benefits on a good faith basis. While it was common to bring a claim of bad faith against an insurance company, we also sued the insurance adjuster who made the decision to terminate our client’s benefits. The insurance company brought a court motion to prevent us from bringing a claim directly against the adjuster. The motions court judge struck the claim against the adjuster. We appealed and the Court of Appeal agreed with us that it was proper to bring a claim directly against the insurance adjuster. This decision meant that insurance adjusters could be held personally responsible if they act in bad faith in denying a person accident benefits.