“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 moreIf causes are not “divisible” damages will flow.
Ms. K. suffered whiplash type injuries in a 2007 car accident. Her pain became chronic and she became depressed. The consensus of the medical experts at her trial was that “her chronic pain is unlikely to resolve and the focus of her treatment should be on pain management, not cure.” Ms. K. admitted that she had a troubled childhood. also, a few years after her accident she experienced a torn rotator cuff, then shoulder surgery and then a frozen shoulder which were all unrelated to her accident. In K. v. Galasinao, 2015 BSSC 1532, Mr. Justice Blok concluded that “there is a significant...
read moreICBC 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...
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