Personal Injury

PI lawyers play a vital role under current claims process

By Staff

With any insurance claim, a protracted battle starts — and a personal injury lawyer’s role is to fight with your insurer to oblige them to honour the policy, Toronto-area personal injury lawyer Darryl Singer writes in The Lawyer’s Daily.

As Singer, principal of Singer Barristers Professional Corporation, explains, many people are under the impression that if they pay their insurance premiums on time and for decades, this will result in a payout for the stated value of the insurance policy if they ever need it.

Unfortunately, he writes, this isn’t often the case.

“What Canadians are really buying when they buy insurance is the right to sue their insurer. Why? Because an insurer’s default position for any claim is: ‘Denied.’ That’s your first ‘Aha!’ moment.”

Singer says the insurance company often views the claimant with suspicion.

“They send out investigators, looking for reasons to back up their hypothesis that you are trying to defraud them. That’s your second ‘Aha!’ moment. You will be presumed not to have a valid claim until you prove it. The only way you can prove it is to hire a lawyer experienced in fighting with insurance companies,” he says.

However, he says, fighting with an insurance company is not a fast or cheap process.

“They bury you in paperwork. And they have well-funded lawyers. The insurance companies hold all the cards,” writes Singer.

Thousands of meritorious insurance claims are made ever year, many of which insurers refuse to pay, he says.

Singer provides examples of typical claims he has dealt with over the last 12 months that started off as “denied” but were successfully settled after a great amount of negotiation and proof.

These include the case of an auto insurer who refused to pay after a client’s vehicle was written off after an accident in which he was T-boned, as the client, in the insurer’s words, “increased the risk of loss” by adding after-market alterations such as a new paint job and a spoiler.

In another case, an elderly client formerly living an independent retirement suffered life-altering injuries when he was hit by a car while crossing at a green light. Singer says the client was denied damages for future care costs as well as pain and suffering.

“Why? According to the actuarial tables of life expectancy, he would be dead soon anyway,” he writes.

Ultimately, although courts have determined insurance policies are ‘peace of mind contracts’ that an individual buys specifically so they know they are covered when disaster strikes, Singer says until insurers “pay out claims in a fair way, without immediate denial and suspicion, if you must make any sort of claim, you will likely need a personal injury lawyer.”

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