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What to Do If Your Personal Injury Claim is Denied: A Guide to the Insurance Claims Process in Canada

What to Do If Your Personal Injury Claim is Denied: A Guide to the Insurance Claims Process in Canada

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If you have been injured in an accident in Canada, you may be entitled to seek compensation for your injuries and losses. In many cases, this compensation will come from the insurance company of the party responsible for the accident. Insurance plays a critical role in personal injury cases, as it can provide financial support to cover the costs of medical treatment, lost income, and other damages.

Here are some key things to know about the role of insurance in personal injury cases in Canada:

  1. Filing a personal injury claim: If you have been injured in an accident, you will need to file a personal injury claim with the insurance company of the party responsible for the accident. This may be the at-fault driver’s auto insurance company, for example, or the owner’s property insurance company if you were injured on someone’s property. To file a claim, you will need to provide information about the accident, your injuries, and any costs or losses you have incurred as a result.

  2. The claims process: The insurance company will review your claim and may request additional information or documentation to support your claim. They may also send an adjuster to investigate the accident and assess the damages. If the insurance company agrees to pay your claim, they will offer you a settlement. If the insurance company denies your claim, you may be able to appeal the decision or negotiate with the company to try to reach an agreement.

  3. Negotiating a settlement: If the insurance company offers you a settlement, it is important to carefully review the offer and consider whether it is fair and adequate to cover your damages. If you do not agree with the settlement offer, you may be able to negotiate with the insurance company to try to reach an agreement. A personal injury lawyer can assist you in negotiating a settlement and advocating for your rights.

  4. Filing a lawsuit: If you are unable to reach a settlement with the insurance company, you may need to file a lawsuit to seek compensation. A lawsuit can be a time-consuming process, so it is generally a good idea to try to resolve your claim through settlement negotiations first. However, if a lawsuit is necessary, a personal injury lawyer can help you build a strong case and represent you in court.

    Navigating the insurance claims process can be complex, especially if you are dealing with the physical and emotional impacts of an injury. A personal injury lawyer can help you understand your rights and options and assist you in getting the compensation you deserve. Don’t let the insurance company deny your claim or lowball your settlement offer – seek legal assistance and stand up for your rights.

  5. What to do if your claim is denied: If the insurance company denies your claim, you may be able to appeal the decision or negotiate with the company to try to reach an agreement. It is important to carefully review the reasons for the denial and gather any additional evidence or documentation that may support your claim. If you are unable to resolve the matter through the insurance company’s internal appeals process, you may need to file a lawsuit to seek compensation.

Our team can help you navigate the confusing world of insurance claims and help you get the compensation you are entitled to. Call us today.

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Understanding the Different Types of Damages Available in a Personal Injury Case in Ontario

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If you have been injured in an accident in Ontario, Canada, you may be entitled to seek damages for the losses and expenses you have incurred as a result of your injuries. In a personal injury case, damages are financial compensation awarded to the injury victim to cover the costs of their injuries and help them return to their pre-accident state.

There are several types of damages that may be available in a personal injury case in Ontario, including:

  1. Medical expenses: If you have been injured in an accident, you may be entitled to seek compensation for the costs of your medical treatment, including hospital bills, medication costs, and rehabilitation expenses.

  2. Lost income: If you have been unable to work due to your injuries, you may be able to seek compensation for the wages or salary you have lost as a result.

  3. Pain and suffering: You may be able to seek compensation for the physical and emotional pain and suffering you have experienced as a result of your injuries. This type of damages is intended to compensate you for the non-financial impacts of your injuries.

  4. Loss of consortium: If your injuries have impacted your ability to have a normal relationship with your spouse or partner, you may be able to seek compensation for the loss of companionship and support.

  5. Property damage: If your personal property, such as your car, was damaged in the accident, you may be able to seek compensation to cover the cost of repairs or replacement.

  6. Punitive damages: In some cases, the court may award punitive damages as a way to punish the defendant for particularly reckless or negligent behavior.

It is important to note that the amount of damages you are entitled to receive will depend on the specifics of your case and the extent of your injuries. Our team at Hilborn and Konduros can help you understand the damages you may be entitled to and assist you in negotiating with the insurance company to get the compensation you deserve. Contact us today.

Philips Canada Recalls CPAP Machines

Philips Canada Recalls CPAP Machines

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In August 2021, Philips Canada, the manufacturer of various CPAP and BiPAP machines issues a recall, stating that the noise-reducing foam used in various models may degrade and potentially enter the air pathway of the device. Once in the air pathway, the particles may be inhaled by the user. 

CPAP and BiPAP Foam Could Contain Carcinogens

The company has announced that while they have not received any notice of death relating to the foam degradation, it has received notices of possible patient impact. 

The listed possible risks of particle exposure include headache, irritation, inflammation, respiratory issues, and possible toxic and carcinogenic effects. In response, nationwide class action lawsuits have been filed against the company, stating that it knowingly manufactured and sold a defective product. 

Here is a full list of the products listed in the recall: 

  1. REMSTAR AUTO WITH SD CARD, A-FLEX, CANADA
  2. REMSTAR AUTO WITH HUMIDIFIER, WITH SD CARD, A-FLEX, CANADA
  3. RESTAR PLUS WITH SD CARD, C-FLEX, CANADA
  4. RESTAR PLUS WITH HUMIDIFIER, WITH SD CARD, C-FLEX, CANADA
  5. RESTAR PRO WITH SD CARD, C-FLEX +, CANADA
  6. RESTAR PRO WITH HUMIDIFIER, WITH SD CARD, C-FLEX +, CANADA
  7. BIPAP AUTO BI-FLEX, WITH HUMIIFIER, WITH SMARTCARD, CANADA
  8. BIPAP AUTO BI-FLEX, WITH SMARTCARD, CANADA
  9. BIPAP PRO BI-FLEX, WITH HUMIDIFIER, WITH SMARTCARD, CANADA
  10. BIPAP PRO BI-FLEX, WITH SMARTCARD, CANADA
  11. RESTART, WITH HUMIDIFIER, WITH SMARTCARD, CANADA
  12. RESTAR, WITH SMARTCARD, CANADA
  13. BIPAP AVAPS, C SERIES VENTILATORY SUPPORT SYSTEM-DOMESTIC
  14. BIPAP AVAPS, C SERIES VENTILAROTY SUPPORT SYSTEM-CORE PKG, DOMESTIC
  15. BIPAP ST, C SERIES VENTILATORY SUPPORT SYSTEM-CANADA
  16. BIPAP ST, C SERIES VENTILATORY SUPPORT SYSTEM-CORE PKG,DOMESTIC
  17. BIPAP ST, C SERIES VENTILATORY SUPPORT SYSTEM, CORE PKG, CANADA
  18. OMNILAB ADVANCED, DOMESTIC
  19. OMNILAB ADVANCED, DOMESTIC CORE
  20. BIPAP AUTOSV ADVANCED SYSTEM ONE
  21. DREAMSTATION CPAP
  22. DREAMSTATION AUTO BIPAP
  23. DREAMSTATIN BIPAP PRO
  24. DREAMSTATION CPAP PRO
  25. DREAMSTATION AUTO CPAP
  26. DREAMSTATION BIPAP AUTOSV, CA
  27. DREAMSTATION BIPAP AUTOSV, W/HUMIDIFIER, CA
  28. DREAMSTATION BIPAP AUTO SV W/HUMID/HEATED TUBE, CA
  29. BIPAP AVAPS VENTILATORY SUPPORT SYSTEM-CANADA
  30. BIPAP AVAPS VENTILATORY SUPPORT SYSTEM-CORE PKG, CANADA
  31. DREAMSTATION GO CPAP
  32. DREAMSTATION GO AUTO CPAP
  33. DREAMSTATION EXPERT
  34. DREAMSTATION GO CPAP WITH HUMIDIFIER, CANADA
  35. DREAMSTATION GO AUTO CPAP WITH HUMIDIFIER, CANADA

Facts About Defective Products Lawsuits 

When a product is produced and sold to the public, the designer and manufacturer of that product are responsible for ensuring that the product won’t cause harm when it is used as intended. Sadly, many products are not properly tested or safety test results are overlooked in favor of profits. 

When an individual is harmed by a defective product they have the legal right to seek compensation for their losses. This is accomplished by filing a defective product lawsuit, a type of personal injury lawsuit. The class action lawsuit filed against Philips Canada is just one example of this type of legal action. 

Contact a Personal Injury Attorney in Ontario 

If you believe that you or a loved one have been harmed by a defective product, the attorneys at Hilborn and Konduros can help. Contact us for a no-cost consultation or call us at (519) 658-6341

Can I Sue If A Car Defect Caused An Auto Accident

Can I Sue If a Car Defect Caused an Auto Accident?

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There are thousands of car accidents each year in Ontario, many caused by a negligent driver. There are times, however, when a defect causes an otherwise attentive driver to lose control and crash. 

Can I Sue A Car Part Manufacturer If I Was Injured In An Accident? 

Yes, Canadian law does give accident victims the right to seek compensation from the party whose negligence caused them harm. When a car accident is caused by a defect, the negligent party is frequently the designer and/or manufacturer of the defective part. 

Car parts that have been found to be defective in the past include: 

  1. Seat Belts
  2. Turn Signals
  3. Brakes
  4. Airbags
  5. Engines
  6. Tires

How Can I Prove A Car Part Was Defective? 

There are important steps that every car accident victim should take following a crash: 

  1. Seek medical care: Don’t hesitate to see a doctor immediately following an accident. 
  2. Take photos: If possible, take photos of the scene of the accident, any injuries that were sustained, and the vehicles involved. 
  3. Collect witness contact information. 
  4. Start collecting copies of all records relating to the accident. This could include police records and insurance paperwork. 
  5. Contact an experienced car accident attorney. 

A car accident lawyer can work to prove negligence in car accident claims. When an auto part is defective, negligence is generally broken down into four categories:

Defective Design

A part can have a significant flaw in its very design, a flaw that exists even before it is manufactured. 

Manufacturing Defect

Just because a product is well designed doesn’t mean that it is manufactured correctly. Poor quality materials, incorrect chemical mixtures, and more can result in a product that fails to perform as it should. 

Failure To Properly Inspect Or Test Products

Things and car designs change rapidly in the auto industry. Every manufacturer must test their new products before it ends up in the consumer’s hands. 

Failure to Warn Consumers

Every manufacturer has the duty to warn consumers about any dangers associated with their products. If they fail to do so, they can be held responsible for any injuries that occur as a result. 

Contact the Experienced Car Accident Attorneys At Hilborn And Konduros

If you’ve been seriously injured in a car accident, contact our Cambridge ON legal team for a no-cost consultation. Call (519) 658-6341 to get started. 

What is Your Duty to Disclose When Applying For Long-Term Disability?

What is Your Duty to Disclose When Applying For Long-Term Disability?

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While most applicants for long-term disability benefits do so through an employer’s policy, many have taken out disability and critical illness policies on their own. And if certain health issues have not been disclosed on the application, these policyholders may be out of luck when it comes to collecting benefits. 

Qualifying for These Benefits

Private insurance policies require you to submit an application to qualify for their coverage. They will make decisions on your qualification ability as well as your premium amounts by examining your application in detail. Qualification and premiums will be dependent on many factors, including your age, health, lifestyle choices, and other risk factors.

Weighing Their Risk

Insurance companies are for-profit businesses, and their goal is to provide less benefits than they take in premiums. Consequently, their underwriters focus sharply on potential risk when considering an applicant. This risk is assessed by how you have responded to questions on your application. If an applicant doesn’t tell the truth on their application, the company can’t assess risk. They also may use that information to deny benefits to you should you need them. And in most cases, those denials are upheld in court if you decide to legally pursue it. 

Your Duty to Disclose

When you are applying for life insurance, critical care insurance, or individual long-term disability insurance, you are required by law to tell the truth about your health. Under Section 183 (1) of the Insurance Act, an applicant for insurance must disclose “every fact within the person’s knowledge that is material to the insurance….”

Getting Legal Guidance

If you have been denied long-term disability benefits or other insurance benefits unfairly, you may have legal recourse. But if the denial involves your own duty to disclose, you may be out of luck. Getting legal guidance is critical. If you believe you have been unfairly denied insurance benefits, the Cambridge ON long-term disability lawyers at Hilborn and Konduros may be able to help. Contact or call us at (519) 658-6341 to schedule a complimentary consultation to discuss your case.

Keeping Accurate Records After an Accident is Vital to Your Claim

Keeping Accurate Records After an Accident is Vital to Your Claim

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The days, weeks, and months after an accident can be overwhelming for an injury victim. Not only will they be bombarded with bills and correspondence from each one of the medical care providers involved, but also potentially with correspondence and information from the associated insurance companies. When someone is trying to focus all their effort on getting better, keeping track of and tending to all of this can be difficult but necessary.

Every single piece of information can be essential to an accident claim, disability claim, or tort lawsuit. If you have been injured in an accident, you must keep rigorous records if you seek compensation for your injuries.

Your records should include

  • Any medical bills and paid receipts
  • Any medical treatment results
  • Other medical records or prognoses
  • Statements from any attending doctors
  • Statements from any insurance personnel
  • Statements from any employers
  • A police report or accident findings
  • Any other expenses or receipts as they may apply to the accident or injuries

These will help provide evidence for your insurance claim and an organized and detailed accounting of evidence and expenses needed for any potential tort lawsuit. 

Keeping Track of Correspondence

Keep any paper or digital correspondence in a designated place. If your correspondence is primarily through email, keep it in a separate inbox folder so it doesn’t get mixed up or deleted with other email correspondence. You may also want to print out each document to have a hard copy and to further categorize it. 

Phone Calls

Anytime you speak with someone on the phone concerning your medical care or speak with an insurance provider, you want to keep detailed notes of what was said. Keep records of any phone conversations noting the date and time of your call, who you spoke with, what topic was discussed, and any further directions you were given.

Keeping a Diary

Keeping a diary of your pain, symptoms, limitations, and other important information is helpful when you are pursuing compensation for your injuries. You will also want to make note of any time you are unable to work because of your injuries or you need to go to doctor’s visits or get treatment for your injuries. 

Getting Legal Assistance

If you have been injured in an accident, getting professional legal advice and assistance may be one of the most important things you do. At Hilborn and Konduros, our team of Cambridge personal injury lawyers can help you understand your rights and assist you with compiling and organizing important records you will need for a personal injury claim. Call us at (519) 658-6341 or contact us online to schedule a no-cost consultation.

Are You Being Watched By An Insurance Company?

Are You Being Watched By An Insurance Company?

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You have filed an injury claim with the insurance company, hoping to be reimbursed for your mounting expenses caused by an accident. But you have the sneaking suspicion that someone is watching you. Are you being paranoid? Maybe not. 

Insurance Surveillance is a Real Thing

The insurance industry’s use of surveillance is a real thing. How common is it? Consider that Ontario’s Workplace Safety and Insurance Board admitted to carrying out nearly 2,500 investigations from 2016 to 2020, many including surveillance. 

Insurance companies have a great financial incentive to watch their claimants closely. Insurance fraud is common. And even legitimate insurance claims can cost them thousands and even millions of dollars, eating heavily into their profit margins. 

Is it Legal to Spy on a Claimant?

It is perfectly legal to watch insurance claimants as long as privacy issues are not violated. 

Insurance companies commonly employ surveillance tactics such as collecting public data on a claimant, watching and tracking any social media activity and even physically following the claimant and videotaping their movements. While insurance companies sometimes have legitimate concerns over fraudulent claims, often they watch claimants in order to 

  • Possibly discredit a claimant
  • Try to get the claimant to drop the claim
  • Reduce compensation and payouts

Unfortunately, surveillance often only captures a mere snapshot of the claimant’s activities, causing the insurance company to make broad inferences subject to that snapshot. It rarely captures the overall picture of a claimant’s struggles with their physical or mental injuries. But once surveillance unearths damaging images or information, the claim can be jeopardized. 

If you feel you are a victim of insurance surveillance, it is best not to confront the party. Anything you do or say can be equally held against you. Your best resource is to contact an injury attorney who can help you understand your rights and possibly take action against the company if your privacy has been infringed on. 

At Hilborn and Konduros, our skilled team of Cambridge, ON personal injury lawyers can help you understand your rights and options when pursuing an injury claim. Call us at (519) 658-6341 or contact us online to schedule a no-cost consultation.