Ending Out-of-Country Medical Insurance Too Quickly May Put Ontario Consumers at Risk

The Canadian Association of Financial Institutions in Insurance (CAFII) warned today that the Ontario government’s decision to end OHIP coverage for emergency services for Ontarians travelling outside Canada could result in many people travelling abroad without adequate insurance coverage if the change is implemented too quickly and without sufficient communication.

The Government has set October 1, 2019 as the implementation date to end OHIP’s out-of-country coverage. But in order for consumers to continue to receive a high level of protection when traveling outside Canada, CAFII says more time is needed – at least a one-year transition period. This longer time frame would allow the Government to undertake a robust, multi-year communications campaign to inform Ontarians about the change and resulting implications. It would also give the industry more time to determine what the new premium rates will be, and to ensure its employees are ready to communicate about the changes and properly serve their customers.

According to CAFII, even under the current situation before the pending change, many Ontarians travel outside of Canada without adequate travel health insurance and without realizing they are at risk of incurring catastrophic financial costs. For example, according to the U.S. Centers for Medicare & Medical Services, the average cost of a three-day hospital stay in the United States is approximately US$30,000, and comprehensive care can run up costs of several hundred thousand dollars or more.

However, by allowing more lead time for the elimination of OHIP coverage for Ontarians travelling outside of Canada, it will provide an opportunity for the Government to inform consumers that OHIP will no longer cover them at all when they travel outside of Canada. It will also allow more time for both the Government and the insurance industry to address the dangerous misconception that private insurance is not necessary when consumers travel outside the country.

“We believe a robust communications campaign by the Government that supplements what the insurance industry is already doing will be critical in mitigating the risk to the travelling public of this change in insurance coverage,” says Keith Martin, Co-Executive Director of CAFII. “That communications campaign should emphasize to Ontarians the importance of having travel health insurance in place before travelling outside Canada, so that they and their loved ones will have immediate access to emergency medical care and related assistance, and can avoid exposure to potentially catastrophic and life-altering financial costs.”

At present, OHIP covers out-of-country inpatient services to a maximum of $400 per day, and up to $50 per day for emergency outpatient care. But when these amounts are no longer covered by OHIP, travel medical insurance will become even more important to have, and the cost will undoubtedly rise, says Martin.

About CAFII: 
The Canadian Association of Financial Institutions in Insurance is a not-for-profit industry Association dedicated to the development of an open and flexible insurance marketplace. CAFII believes that consumers are best served when they have meaningful choice in the purchase of insurance products and services. CAFII’s members include the insurance arms of Canada’s major financial institutions – BMO Insurance; CIBC Insurance; Desjardins Financial Security; National Bank Insurance; RBC Insurance; ScotiaLife Financial; and TD Insurance – along with major industry players Assurant; Canada Life; Canadian Premier Life Insurance Company; CUMIS Services Incorporated; and Manulife (The Manufacturers Life Insurance Company).

SOURCE CAFII

Cyclist Struck in Marked Crosswalk Found 100% at Fault for Crash

Reasons for judgement were published today by the BC Supreme Court, Vancouver Registry, dismissing a personal injury claim involving a cyclist struck by a vehicle.

In today’s case (Dhanoya v. Stephens) the Plaintiff cyclist rode into a marked crosswalk without stopping and was struck by a vehicle.  The Court found the cyclist was fully at fault for the collision and had the cyclist kept a proper lookout the collision could have been avoided.  In finding the cyclist solely liable Madam Justice Dillon provided the following reasons:

[13]         After consideration of all of the evidence and particularly after considering the evidence of the plaintiff in the context of all of the evidence and the surrounding circumstances, the evidence of the defendants and Woermke is accepted as to how the accident occurred. It is accepted that Jodie Stephens first saw the plaintiff as the plaintiff approached the intersection on his bike. Although Mr. Stephens was inconsistent as to his exact position when he first saw the plaintiff, it was from 15 to 30 feet from the crosswalk, close enough for the driver to have little option in the circumstances. He was travelling at about 35 kph initially and this estimate of his original speed was supported by Woermke. It was apparent to Mr. Stephens that the plaintiff was not going to stop. Mr. Stephens applied his brakes, managing to slow down to five to ten kph before impact. As described by Woermke, the plaintiff rolled into the crosswalk without stopping or looking. The plaintiff admitted that he bicycled across the crosswalk. He said that he stopped at the crosswalk, put his foot down, and looked for cars for a minute. He did not see the defendants’ vehicle approaching: if he had, he stated that he would not have entered the crosswalk. Clearly, the vehicle was there to be seen. Mr. Stephens realized that the plaintiff had not seen the Stephens vehicle and had not made eye contact so to judge his own safety. The plaintiff was on his usual route, on a bright day, getting close to his destination, with a perception that there were few cars on the road. In the scenario of little perceived traffic, it is concluded that it was the plaintiff’s usual practice to bike across the crosswalk. He followed that practice on the day of the accident. He did not stop and look both ways, else he would have seen the approaching vehicle which was 30 feet away from the crosswalk at most.

[14]         The driver of a motor vehicle has a general duty of care to keep adequate lookout for recognizable hazards on the road (Dobre v. Langley, 2011 BCSC 1315 at para. 34). A driver approaching a marked crosswalk assumes a heightened duty to take extreme care and maintain a vigilant lookout for those that might be in the crosswalk (Dobre at paras. 35 and 43). It is important to remember that the standard of care is not one of perfection, but whether the driver acted in a manner which an ordinarily prudent person would act (Hadden v. Lynch, 2008 BCSC 295 at para. 69).

[15]         A cyclist shares the same rights and duties with drivers of a motor vehicle (Dobre at para. 32). The duties specific to a cyclist are set out in s. 183 Motor Vehicle Act, R.S.B.C. 1996, c. 318. The plaintiff was riding his bicycle in a crosswalk in contravention of s.183 (2)(b) Motor Vehicle Act. He had a duty to keep a proper lookout (Dobre at para. 35).

[16]         Because of this violation of the traffic law, the plaintiff assumed a heightened duty to ensure his own safety, particularly to ensure that he was seen by other drivers (Hadden at para. 59; Dobre at para. 39; Callahan v. Kim, 2012 BCSC 1615 at para. 23). As acknowledged by the plaintiff, he did not have the statutory right of way when he bicycled across the crosswalk because he was not a pedestrian (Dobre at para. 34). Nonetheless, a reasonably careful and skillful driver has a duty to give way to a user of a crosswalk where there is an expectation that pedestrians and other users will be present (Callahan at para. 18). However, in the circumstance of the plaintiff’s failure to yield the right of way, he must establish that, after the defendant became aware that the plaintiff was proceeding onto the crosswalk, the defendant had sufficient opportunity to avoid the accident of which a reasonably careful and skilled driver would have availed himself (Hadden, at paras. 67-68). The plaintiff must establish that he was a recognizable hazard and that his actions left the defendant with enough time and distance to see and avoid striking him (Dobre at para. 34).

[17]         The plaintiff alleges that Mr. Stephens was not operating his vehicle at a reasonable speed in the circumstances, notwithstanding that he was travelling at below the speed limit. The plaintiff also says that Mr. Stephens was distracted by the conversation in the car, so failing to take due care and attention. The plaintiff maintained that the defendant breached the standard of care when he failed to yield the right of way to the user of the crosswalk and that this failure was the cause of the accident.

[18]         Mr. Stephens saw the plaintiff as he cycled towards the crosswalk and anticipated that the plaintiff was going to cycle right into the crosswalk. Although he admitted that he was in conversation with others in the vehicle, the evidence does not establish that he was so distracted so as not to notice the plaintiff as he was at the intersection and as he entered the crosswalk. The defendant was not speeding. He immediately slowed, braking to avoid a collision. He also tried to make eye contact with the cyclist. The defendant did not have sufficient opportunity to avoid the accident. A reasonably careful and skilful driver could not have avoided this accident.

[19]         The plaintiff did not exercise a reasonable degree of care when he cycled into the crosswalk without looking for vehicles. He did not exercise the expected degree of care for his own safety. He assumed that there was no traffic and cycled into the crosswalk without looking. Had he looked, he would have seen the defendant’s vehicle. Had he looked, the plaintiff would have made eye contact with Mr. Stephens who was alert to make contact. Had he looked, the plaintiff would not have proceeded into the crosswalk. Had he looked, this accident could have been avoided. The plaintiff is the author of his own misfortune.

[20]         The plaintiff is 100% at fault for the accident of November 21, 2015.

Ontario creating task force to improve flooding resilience

TORONTO _ Ontario is creating a task force on improving the province’s resilience to flooding, following high water levels this spring in several communities.

Premier Doug Ford and Natural Resources Minister John Yakabuski said in a statement that the government will work to better plan for and reduce the impacts of flooding.

“Over the past couple of weeks, we have seen first-hand the devastating effect of flooding on our communities,” they said in the statement Friday. “The people of Ontario can’t go through this every year. Something needs to change.”

The task force will consult with municipalities, including in the Muskoka region, Pembroke and the Ottawa Valley.

Ontario has activated a disaster recovery assistance program for residents in Bracebridge, Huntsville, Pembroke, Renfrew County, Ottawa, Clarence-Rockland, Champlain and Alfred and Plantagenet.

The program helps cover emergency expenses and the costs to repair or replace essential property not covered by insurance after a natural disaster.

The task force announcement comes not long after the Progressive Conservative government cut conservation authorities’ funding for flood management in half.

Conservation authorities forecast flooding and issue warnings, monitor stream flow, regulate development activities in flood plains, educate the public about flooding and protect natural cover that helps reduce the impacts of flooding.

Ontario had given $7.4 million to the conservation authorities for that work, but they say that has now been reduced by 50 per cent.

Yakabuski has said the government is trying to eliminate the deficit _ currently at $11.7 billion and has asked conservation authorities to focus on their core mandate, which includes flood control.

NDP environment critic Ian Arthur said the task force should start by reversing those cuts.

“Any review of flood management in Ontario should begin with undoing the damage done by the (Doug) Ford Conservatives,” Arthur said in a statement.

$160,000 Non-Pecuniary Assessment for Head Injury With Lingering Cognitive Issues

Source: Erik Magraken BC Injury and ICBC Claims Blog

Reasons for judgement were published this week by the BC Supreme Court, Vancouver Registry, assessing damages for a mild traumatic brain injury caused by a collision.

In the recent case (Dube v. Dube) the Plaintiff was injured as a passenger involved in a single vehicle collision.  The Defendant accepted fault.  The crash caused a variety of injuries including a traumatic brain injury which caused cognitive deficits which were expected to linger indefinitely.  In assessing non-pecuniary damages at $160,000 Madam Justice Burke provided the following reasons:

0]         Based on my review of the medical evidence, I find that Ms. Dube suffered a head injury or MTBI, and physical injuries to her head, neck, back, shoulders, right leg, and abrasions and contusions to her chest, abdomen and elbow. The impact of the MTBI has created the debilitating injuries affecting Ms. Dube’s cognitive functioning. She has headaches, fatigue, memory issues, speed impediment, multi-tasking issues and anxiety.

[51]         I do not agree with the defence that Ms. Dube’s earlier medical or employment history establishes that she was “generally” disabled or reluctant to work. Rather, the evidence establishes that work was an important part of Ms. Dube’s active lifestyle. The evidence shows that Ms. Dube was committed to recovery and eager to participate in the workforce.

[52]         Both the medical and lay evidence establish that Ms. Dube has been unable to return to her previous activities and has become socially withdrawn. The only expert who opined that Ms. Dube was not disabled as a result of the accident was Dr. Arthur, who does not have any expertise with respect to cognitive functioning and its impact on Ms. Dube’s ability to do her job. Dr. Teal’s opinion was undermined by its reliance on an inaccurate fact. Accordingly, I conclude that as a result of the accident, Ms. Dube will continue to suffer from cognitive impairment and chronic pain to some degree…

[65]         As noted earlier, Ms. Dube suffered a variety of injuries in the accident including a MTBI. The witnesses painted a fundamentally different picture of Ms. Dube before and after the accident. She will continue to suffer ongoing cognitive problems (including memory issues) that have contributed to her social withdrawal. These symptoms have impacted her significantly. Her friends and family have corroborated this.

[66]         As noted in Stapley, the assessment of non-pecuniary damages depends on the particular circumstances of the individual. I have concluded that the authorities provided by the plaintiff are more useful than the authorities offered by the defendant in assessing the case at bar. This is largely because the types of cognitive impairments that I have found to exist in this case are not particularly evident in the defendant’s authorities. I have considered Ms. Dube’s age as well as the nature of her injuries and her ongoing symptoms. I make specific note of the evident distress she has experienced due to the cognitive impact of her injuries, her impact of that on her life generally and her withdrawal from social activities. I am of the view that an appropriate award for non-pecuniary damages is $160,000.

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Access Duration from the Date of Purchase: 6 months
Credit Hours: 3
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Accrediting Provinces: QC
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