The doughnut shop fight that made the Ontario Court to protect the policyholder’s personal injury claim

The incident that took place a couple of years from now, i.e. in the month of February, 2011 forced the Ontario court to rethink on the personal injury claims, when it was found that the insurance policy excludes coverage for any kind of criminal acts. As a result, the Ontario court planned to issue orders to the insurer to guard the personal injury claim of the policyholder, when it was found that the policyholder, who was found guilty of assaulting the man, who is now suing him. 

Fausto Simone and Vincenzo Sgambelluri are the names of the persons involved in the fight. It all happened when Sgambelluri supposedly ran into the drive-through line. He has now sued Simone for all the alleged personal injuries namely broken leg, depression and anxiety, which he had to suffer because of Simone’s negligence.   

After several discussions, Simone received a conditional discharge as he was found to be guilty of common assault. But, as per the court records, the judge of the trial was “not convinced beyond a reasonable doubt” that Simone was responsible for any attack causing bodily harm. As written by Mr. Justice Bruce Glass in background with his May 31, 2013 decision on Economical’s duty to defend, “The trial judge found that there had been a chest bumping between the two men". 

Furthermore, the judge with the Ontario Superior court of Justice found that the proceedings could be based on those negligent actions that are not grouped under criminal actions. This caused the Ontario Court issue orders to the insurance company to protect the lawsuit against the policyholder for those personal injuries allegedly resulting from such an action.

When Simone found that the insurance policy he had, offers no coverage against the criminal acts, he applied to the court for a declaration asking economical insurance for his defence. But the insurance company, on the other hand, argued that the policy which Simone holds does not offer any kind of compensation for personal injuries developed as a result of any intentional criminal acts or failure to act.  

After scrutinizing all the proofs and studying the entire case, on May 31, 2013, Judge Glass ruled the decision in favour of Simone saying that he "is entitled to declaratory relief" and ordered the insurance company to support him "with the exception of a claim for punitive or exemplary relief," since punitive and exemplary damages are excluded from the insurance policy.

"There will be an order for a declaration that the Respondent defends the action," Judge Glass wrote.

Looking at the possibility that Simone could go for a negligence claim, Judge Glass in his ruling also suggested, exclusions of Simone's policy with Economical Insurance would not apply. However, "If there is a realistic possibility that a claim in negligence might be advanced separate from a claim for damagesresulting from an assault, the insured is entitled to benefit of a defence being carried by the insurer," Judge Glass wrote, noting that when determining whether a carrier has a duty to defend, a court must look "beyond labels used" by a plaintiff and "determine the substance and true nature of the claims."

How to Claim for Road Traffic Accidents?

Like any other type of personal injury claim, even road traffic accident claims play a major role in helping you meet some of the immediate and day to day expenses. If you have been injured because a motor-cycle, van, car or any other vehicle hit you, while you were walking besides the road or driving, you can make a claim against the third party who was responsible for the accident or against the insurance company or both. Besides this, you can also claim for the injury if you were unfortunate to meet with an accident while on holiday.

Actions to be performed before filing a claim

Once you are done with the initial medical treatment, to get started with the claim procedure, you will have to prove that a third party was responsible for your injury. In this case, you will have to prove that the accident happened because of the fault of the driver of the vehicle in which you were traveling or because of the driver of the other vehicle that collided with you.

Similar to other types of personal injury claims, you must keep all your documents, evidences and proofs to support your case ready beforehand. Collect names, addresses, telephone numbers and other important data about the faulty. If there were any people present at the accident spot who can narrate the situation well and help you in getting the decision in your favor, then gather information about these witnesses as well. 

Make sure that you report the police about the incident as soon as possible. If you are planning to ask remuneration for damages like lost wages, traveling expenses, and rehabilitation costs and others, ensure that you collect all the receipts and furnish them before the court when asked for.  

The court has statute of limitation on the time period within which you must bring the injury to the notice of the court. But before this, even the insurance companies follow strict deadlines for filing a claim. Neglecting this factor might put your claim in jeopardy and complicate the claim process even more. Therefore, make sure that you take a note of this aspect and report the injury to the insurance company within the specified time interval. 

Consulting a personal injury lawyer is highly recommended, since being the injured party it is very difficult to perform all these tasks. Even if you miss out on a single aspect, it may cost you a lot. There are several personal injury attorneys in Toronto that assist the victims of road traffic accidents in fetching a fair claim for the damages suffered. you can consult any of these lawyers to get the case settled on your side.

Lawyers Can Help You Get Maximum Compensation for Your Personal Injury Claim

You can certainly file for a personal injury claim and win it even without the assistance of a personal injury lawyer; however the process would be far more tedious and daunting than what it would have been with a lawyer on your side. 

Being a common man, not each one of us posses the knowledge required for understanding and abiding by the rules and regulations of the claim procedure. Moreover, as a victim of personal injury you already have so much to deal with. If you decide to claim for the injury all alone, the task gets even tougher. Therefore, it is very certain that you probably miss out on some aspects that can put your claim in jeopardy. Hence, it is recommended to hire a lawyer, as they take care of the proceedings on your behalf so that you can concentrate on more important matters and take good care of yourself for faster recovery. 

It is only if you understand the significance of the claim amount, you will understand how important it is to hire a personal injury lawyer, as they are equipped with the ability to negotiate rightful compensation for their clients. Most of the insurance companies make every possible move for settling the compensation amount to a minimum value. Not being a law student or professional, we may lack the knowledge about these tricks and fall prey to such wrongful deeds losing out a lot on the claim. But if you have a lawyer on your side, you can surely avoid these kinds of losses. 

It is not just that you file a claim, you are offered with the money and other required help. A fair representation in the court is equally important for winning the case. There are so many documents like medical report, police report, rehabilitation bills, and other expenses that the injury had cost you right from the day of the mishap, you need to furnish to the court in order to justify the amount you have asked for is fair in all terms. Most of the victims and their families fail to take note of these points and as a result have to satisfy with a small or unfair amount. But with the help of a lawyer you can gather all the necessary proofs and get maximum compensation for your personal injury claim. 

More information on Hanson Duby is available by visiting the firm's web site at http://www.HansonDuby.com, or by calling (416) 588-9100.