“Internal Appeals” are WORSE than a waste of time.
If an insurance company denies or terminates a claim for long-term disability benefits, the insured should not get side-tracked with the internal “appeal” process. If the goal is to have the insurer reverse their decision, or to reach a settlement with the insured, the fastest way to do this is by litigation. Let me tell you why. Let’s begin with a bit of background about internal appeals and litigation. If one disagrees with the insurance company’s decision about a claim (that is, to deny the application for long-term disability benefits, or to stop payment of benefits), then...
read moreManulife applied to have me disqualified from suing them, and lost.
On November 30, 2015, the BC Supreme Court dismissed arguments by the Manufacturer’s Life Insurance Company, attempting to have me disqualified from acting as plaintiff ‘s counsel in a breach of contract claim against them.
read moreWhat is a Functional Capacity Evaluation?
Functional capacity evaluations, functional assessments and functional abilities evaluations are all different names for the same thing: a series of tests and observations used to estimate your ability to function at work. For simplicity I will just refer to them collectively as functional capacity evaluations. Functional capacity evaluations (FCE’s) usually take place over one or two days and are administered by a health professional (usually an occupational therapist, physiotherapist or kinesologist). The testing usually will take the entire day (for a one-day FCE) or a day and half (for a...
read moreSupreme Court Judge: ICBC doctor a “very unhelpful medical witness”.
On December 23, 2015, the BC Supreme Court criticized a defence expert witness for crossing the line into advocacy. In Ferguson v. McLaughlin the plaintiff was injured in a 2009 collision caused by the defendant. The defendant’s insurer hired a physician who presented evidence largely discounting the connection of the plaintiff’s complaints to the collision. In rejecting this evidence Madam Justice Griffin made the following pointed comments: [63] The defendant called the evidence of Dr. Duncan McPherson, an orthopaedic surgeon, who performed a medical examination of the plaintiff...
read moreExpert did not meet with, examine or interview plaintiff = NO WEIGHT.
On November 30, 2015, the BC Supreme Court rejected the opinion of a defence retained doctor who “did not meet with, examine or interview” the plaintiff but nonetheless authored a report opining on the plaintiff’s injuries. In Preston v. Kontzamanis Mr. Justice Parrett provided the following critical comments for medico-legal practices: [125] The defendant provided and relied upon what purported to be an independent medical report (IME) by Dr. Boyle. [126] Dr. Boyle readily acknowledged that he was not asked to and did not meet with, examine or interview the plaintiff. [127] Dr....
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