Determining Future Loss of Income

Do you renew your automobile coverage without asking any real questions? Do you simply take what coverage you had last year and repeat it again? In this episode, Nigel and Bill give listeners some great advice on how to make sure that any person buying insurance, and his or her family, has adequate coverage in the event of an accident and will help guide the next discussion a listener has with his or her insurance broker. When an accident happens, having the right insurance coverage is absolutely critical.

Alfonso Campos-Reales is an associate lawyer in the injury and disability team who gives a very personal interview with Bill & Nigel about his experience in coming to Canada, becoming a lawyer, and working closely with his Spanish-speaking community. Lerners LLP is proud of Alfonso and all that he brings to the firm and to his clients.

Bill and Nigel love a challenge: this week there are two tough questions dealing with whether the injured person, or the insurance company, get to select the rehabilitation team to be used after an accident as well as what happens when more than one person is injured in an accident and there may not be enough insurance coverage available from the driver responsible for the accident.

Episode 2 Transcript


Episode 2 Q&A

Q: I’ve been in an accident and there were three other vehicles where other people were also hurt and none of those vehicles, including my own, were at fault. My question is what happens if the vehicle which actually caused the accident doesn’t have enough money or insurance coverage to pay all of us in full. What happens then?

A: In the Province of Ontario anyone driving an automobile is required to have no less than $200,000 worth of insurance. No insurance company in Ontario sells policies anymore that have less than $1,000,000. I don’t know the specific facts of your case but let’s put together a scenario. Let us assume the person that was driving the car that was at fault only has $500,000 worth of insurance, and let’s assume that three people are injured, including yourself, and each of you has an injury that’s worth $1,000,000. Now you have $3,000,000 worth of injuries but there is only $500,000 worth of insurance to cover that. If you have an insurance policy where the amount of insurance you have is greater than the insurance of the person that caused your injury, and your damages are greater than the amount of insurance they have, then you can go to your insurance company and seek the difference between the insurance they have and the insurance you have. To try and go back to the analogy for a minute, what that would mean then is if you have a $1,000,000 injury, there is $500,000 that the other driver has. That money unfortunately gets split equally between the three people that were injured, yourself and the two other people, so you split the $500,000. You then go to your own insurance company. Unfortunately, you do not get the difference between what you actually got and the $1,000,000 from your own insurance company because the law treats it as though each individual person was injured by the driver of the at fault car without anyone else being involved. In other words, they treat it as though you got the $500,000 from the other person, the other two people got $500,000 from the other person, even though they didn’t, and in that case, you would actually be able to collect from your own insurance company $500,000 because your injury was $1,000,000 yet you wouldn’t actually realize the full $1,000,000. What that is called is “under insured coverage” and every automobile policy written in the Province of Ontario has to have that in the policy. One of the things that people really need to do and look at, is determine how much insurance do I have. It’s not there just to protect you in the event that you injure somebody else, it’s there to protect you in case somebody else injures you. Taking my example, if your injury was in fact worth $2,000,000 you would have only received $500,000 from your own insurance company. Had you had a $2,000,000 insurance policy, then you would have been able to receive $1,500,000 from your own insurance company after collecting your share of the $500,000 from the person who caused the accident. Long answer, but that’s because it’s a very complex area of the law.


Q: I’ve been in an accident and my insurance company is offering to come to the hospital and set up my rehab and put into place the treatment providers that I need. Should I be concerned about this?

A: The short answer would be yes, but of course, short answers are not always the right answers, or easy answers are not the best answers. There are a number of things you have to consider and one is the extent of the severity of your injury and what rehab is going to be involved. One of the concerns you should always have is when the insurance company has offered to do things for you. What is it that they want from you in return? Insurance companies often are trying to get their insureds better, back to their life and back to work as quickly as possible but they are also trying to get information they can potentially use against you down the road. If they are going to go to the hospital to see you, often they will ask you to sign a release form so they can obtain information from your family doctor. That information won’t be just about the injury you suffered. They are going to ask for information before you were injured which may disclose information you may not want them to know about. They are going to ask you to see their rehabilitation people. You have the right to pick your own rehabilitation people and the question really is, are the people the insurance company picking the best people for the type of injury you have, and are they really going to do the best job for you. You have the absolute right to select the treatment provider who you think is best qualified and best suited to help you in your situation. You don’t have to have forced on you a person the insurance company puts forward as a possible therapist. All insurance companies are not the same, even individual adjusters within the insurance companies aren’t the same. We are not suggesting that insurance companies in every case or every situation are out to do something improper at all. This is a situation where you will be far better off to get some advice from a lawyer beforehand who can advise you on your particular facts and circumstances, on your particular insurance company and, on particular rehabilitation people they are suggesting. Even if they have called and said they want to come and see you, find out who it is that wants to come in, who are the people they are suggesting look after you and provide you with your rehabilitation. Before saying yes, say, let me get back to you, and seek that advice. Then you can decide after you have been given that advice whether you want to proceed forward with your insurance company in that way or perhaps in another manner that may have been suggested in the meeting with the person giving you legal advice. All the lawyers at Lerners are very well connected with rehabilitation therapists and the medical community at large so one of the benefits is when you hire a Lerners’ lawyer, you also essentially hire a team. If you are uncomfortable with the idea that your insurance company is going to put together your treatment team, your lawyer can give you some advice about that and make recommendations on individual therapists who might be best so you don’t have to fumble trying to find people to help you all by yourself. If you are going to speak to a lawyer it’s important to not call your family lawyer. You may have a family lawyer that has looked after your last house sale or done some work like your Will. Calling them is not the best thing because this area is very complex and unless you are dealing with somebody who specializes in the area that deals with this type of law day in and day out, they are really not going to be able to give you the information you need to have in order to make an informed decision. That lawyer could possibly suggest somebody else, but what you really need to do is make sure whoever it is you are looking to hire has an expertise in this area. At Lerners, there are a number of lawyers who do nothing but this type of work and have expertise in this particular area of the law, and that is very important.

Nigel Gilby

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Bill Simpson

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