How Multiple Car Accidents may complicate the Claims Process

Posted by Injury Lawyers of Ontario on April 20, 2016

When Injuries and Claims are complicated by Multiple Accidents

Dealing with personal injury claims can be an complicated process in which a number of factors are considered in determining fault and liability. In civil liability cases, injured parties will seek compensation for the injuries that they incurred as a result of an incident. The majority of cases are resolved through negotiation but sometimes resolution of such cases lands in the hands of the courts. Consider what would happen if the plaintiff was previously involved in one or more separate incidents that resulted in pre-existing injuries. How does one determine liability and appropriately apportion fault if there are subsequent injuries involved?

Multiple injuries certainly complicate personal injury claims. The difficulty comes at the point of apportioning fault. At what point can you segregate the recent injuries from the pre-existing ones? What if the pre-existing injuries contribute to the severity of the recent injury? From one viewpoint, the defendant insurer may be reluctant to compensate the injured party for pre-existing injuries that were caused by the perhaps negligent actions of an outside party. From a plaintiff’s perspective, the existence of already established injuries does not negate the liability of the current defendant for the latest injuries sustained, and a relevant consideration is that the injury and losses would likely not have worsened if not for the latest accident.  The Court of Appeal for Ontario was faced with the challenge of determining fault and damages in a complicated case involving multiple causes of injury in Monks v. ING Insurance Co. of Canada.  

Monks v. ING Insurance Company of Canada

In Monks v. ING Insurance Company of Canada, the plaintiff had been involved in two prior car accidents, one in 1993 and another accident two years later in 1995. Following the 1995 accident, the defendant sued Zurich Insurance Company (who was then her insurer) for payment of accident benefits that had been denied. Zurich subsequently paid Ms. Monks $1.275 million in damages.

Three years later, the plaintiff was involved in a third accident. This latest accident resulted in the plaintiff becoming an incomplete quadriplegic, which entails partial damage to the spinal cord that causes paralysis. With incomplete spinal injuries some motor and sensory function may remain. The plaintiff became largely confined to a bed and dependent on attendant care and medications. She was unable to work and earn a living as a result of her injuries.

After paying the plaintiff’s accident benefits for three and a half years, ING Insurance, the defendant insurer, terminated payments and requested repayment of some past payment, claiming that the plaintiff was not “catastrophically impaired” as defined in the Statutory Accident Benefits Schedule (SABS), which is the statutory basis for compensating the plaintiff.  However, at the trial, the defendant backpedalled somewhat on their initial allegation; ING Insurance admitted that the plaintiff’s injury was catastrophic but argued that it was a combination of the subsequent accident and the pre-existing spinal condition that caused her impairment. The trial judge in this case decided that the third accident “materially contributed to the plaintiff’s condition and to the deterioration or duration of her symptoms, despite the role of prior accidents and alleged pre-existing conditions.”  Accordingly, the judge declared that the plaintiff was entitled to medical and rehabilitation benefits, attendant care benefits as well as housekeeping benefits on an ongoing basis.  The plaintiff was awarded $50,000 in aggravated damages and a risk premium of $75,000.

On appeal, the court ruled that the trial judge did not err in the decision to grant ongoing entitlement to statutory accident benefits and correctly applied the “material contribution” test in determining causation.  The appeal judge also rejected the defendant’s argument that it should not be obligated to compensate the plaintiff until Zurich’s settlement monies were exhausted.  In order to address the issue of ‘double recovery’ (which prevents a claimant from being awarded costs or damages for the same loss twice), the plaintiff proposed a solution that involved immediately receiving accident benefits from ING, but minus the monthly amounts paid for medical, attendant care and other expenses by Zurich.  The judge agreed with Ms. Monks’ suggestion.  However, the appellate judge did, however, find that the trial judge erred in awarding the risk premium.

In this case, the ING Insurance was judged to be responsible for compensating Ms. Monks, despite the claim of pre-existing spinal disease and injuries from previous accidents. The third accident was deemed to have contributed to the plaintiff’s severe impairment, therefore, the defendant was obligated to pay for the plaintiff’s resulting losses.

Indivisible Injuries

Multiple injury cases can involve indivisible injuries, which are injuries that are impossible for a judge to separate from injuries that resulted from a different event. In contrast, a divisible injury case would involve multiple parties that contribute to specific, separable injuries. For example, if one accident resulted in the loss of a leg, but the other resulted in a spinal injury, the injuries would be considered ‘divisible’.  In this scenerio, each party is responsible for the specific harm that they caused to the plaintiff. Indivisible injuries are also compensable, but more difficult to apportion fault.

In Bradley v. Groves, the Supreme Court of Canada denied leave to hear the defendant’s appeal of the appellate decision (which means that the ‘appeal of the appeal’ was not allowed to proceed). In this case, the plaintiff had been involved in two car accidents that were several months apart. The plaintiff sought damages from the driver that caused the first accident. As a result of the appellate judge’s inability to separate the first injury from the second, it was ordered that the first defendant pay for all damages incurred by the plaintiff. This decision was appealed and upheld.

Apportionment of Fault

In cases of multiple injuries, the apportionment of fault can become convoluted. In Bradley v. Groves, the process of apportionment was approached quite simply by assigning all responsibility of compensation for damages to the first defendant. The Supreme Court of Canada’s decision to deny the defendant’s appeal in Bradley v. Groves, sets a precedent that makes it easier for injured individuals to recover damages for their indivisible injuries. Ensuring that injured parties are fairly compensated for their injuries and losses is very important in personal injury claims. Multiple injury cases certainly makes the process more complicated but not impossible as demonstrated in the cases above.

Make an appointment at an Injury Lawyers of Ontario (ILO) law office near you, to ascertain the strength of your case and our knowledgeable team can help you obtain owed compensation.

 


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