Liquor Liability - 2

In Childs v. Desmoreaux, [2006] 1 S.C.R. 643 at para. 19-20, McLachlin C.J. noted that the strict regulation of the sale and consumption of alcohol by the government imposes special responsibilities on those who profit from its sale and duties to reduce the risk associated with its sale:

"Second, the sale and consumption of alcohol is strictly regulated by legislatures, and the rules applying to commercial establishments suggest that they operate in a very different context than private-party hosts. This regulation is driven by public expectations and attitudes towards intoxicants, but also serves, in turn, to shape those expectations and attitudes. In Ontario, where these facts occurred, the production, sale and use of alcohol is regulated principally by the regimes established by the Liquor Control Act, R.S.O. 1990, c. L.18, and the Liquor Licence Act, R.S.O. 1990, c. L.19. The latter Act is wide-ranging and regulates how, where, by and to whom alcohol can be sold or supplied, where and by whom it can be consumed and where intoxication is permitted and where it is not.

These regulations impose special responsibilities on those who would profit from the supply of alcohol. This is clear by the very existence of a licensing scheme, but also by special rules governing the service of alcohol and, as noted above, special training that may be required. Clearly, the sale of alcohol to the general public is understood as including attendant responsibilities to reduce the risk associated with that trade."

McLachlin C.J. emphasized the expectations of the public and the means that commercial hosts have to meet those expectations through monitoring of alcohol consumption:

"…The public expects that in addition to adherence to regulatory standards, those who sell alcohol to the general public take additional steps to reduce the associated risks. Furthermore, patrons are aware that these special responsibilities have very real and visible manifestations. The imposition of a "cut-off" at the bar is understood, and expected, as part of the institutionalization of these responsibilities. Similarly, in many establishments, "bouncers" both enforce admission and assist other members of the staff who might have to deal with patrons who may have become intoxicated. These features have no equivalent in the non-commercial context. A party host has neither an institutionalized method of monitoring alcohol consumption and enforcing limits, nor a set of expectations that would permit him or her to easily do so."

Commercial hosts have an incentive to over-serve: it is more profitable than encouraging responsible consumption. The costs of over-consumption are borne by drinkers, taxpayers and third parties, while tavern keepers enjoy large profits:

"Third, the contractual nature of the relationship between a tavern keeper serving alcohol and a patron consuming it is fundamentally different from the range of different social relationships that can characterize private parties in the non-commercial context. The appellants argue that there is "nothing inherently special" about profit making in the law of negligence. In the case of alcohol sales, however, it is clear that profit making is relevant. Unlike the host of a private party, commercial alcohol servers have an incentive not only to serve many drinks, but to serve too many. Over-consumption is more profitable than responsible consumption. The costs of over-consumption are borne by the drinker him or herself, taxpayers who collectively pay for the added strain on related public services and, sometimes tragically, third parties who may come into contact with intoxicated patrons on the roads. Yet the benefits of over-consumption go to the tavern keeper alone, who enjoys large profit margins from customers whose judgment becomes more impaired the more they consume. This perverse incentive supports the imposition of a duty to monitor alcohol consumption in the interests of the general public."

U.S. Court of Appeals imputes knowledge of insurance agent or broker to insured

I have been discussing the case of Gargano v. Liberty Int'l Underwriters, Inc., in which the court held that under a claims-made policy a claim must be both made and reported during the policy period.

In my last post I discussed the plaintiff's argument that he should not be bound by the terms of the policies because he never received copies of them. As I discussed in my last post, the court rejected that argument.

The court also rejected the argument because the policy was delivered to the plaintiff's insurance agent or broker. "Under Massachusetts law, the agent's knowledge of the policy's terms is imputed to the insured in this circumstance."

Insurance Success Tip #5 - Remove Coinsurance Penalties

Coinsurance in property insurance is a penalty clause - a penalty assessed at the time of a loss. Coinsurance never helps the insurance buyer - it only hurts you. Get your agent to remove all coinsurance penalties from your property insurance.

Insurance Success Tip #4 - Work Only With Great Insurance Agents

The most important part of the insurance transaction is the relationship you have with your insurance agent. If you don't have total confidence in your agent, find another agent - now.

Insurance Success Tip #3 - Buy High Limits of Liability Insurance

Do not skimp on liability insurance limits.

A $1,000,000 umbrella liability policy is a "must-have" for all businesses.

For companies over ten employees, my recommendation is at least $3,000,000.

For most small businesses $5,000,000 is quite affordable.

Best approach: have your agent quote $1 million, $3 million, and $5 million. You will be surprised at how inexpensive the coverage is.

Make your decision based on the value of the coverage compared to the premium charged.

Court of Appeals holds that insured is bound by terms of the policy even if the policy was never delivered to him

In my last post I discussed Gargano v. Liberty Int'l Underwriters, Inc., in which the plaintiff sought coverage under claims-made policies even though the underlying claim was not both made and reported in any single policy period.

The plaintiff argued that the companies should not be allowed to rely on the requirement that a claim be made and reported during a policy period to deny the claim because the insurers had never delivered copies of the policies to him. The court held, "[a]s a general matter 'neither delivery nor actual possession by the insured is essential to the making of an insurance contract unless the contract expressly sets out a requirement of delivery.'"

Liquor Liability - 1

Commercial establishments serving alcohol to patrons have duties under statute and common law to patrons and third parties who may be injured by intoxicated patrons. The duty is to take positive steps to prevent patrons from becoming impaired. Alcohol providers may be liable even though the patron was intoxicated upon arriving at the establishment and despite the patron not showing obvious signs of intoxication. It is the provider’s responsibility to ensure an appropriate system of service and ongoing monitoring is in place to prevent injuries as a result of intoxication. The Liquor Licence Act prohibits service of alcohol to one who is or appears to be intoxicated. The Court of Appeal for Ontario recently held that a plaintiff may call evidence of over-service of patrons of the hotel before, during and after the incident and is not restricted to evidence from the night of the incident giving rise to the lawsuit. Taverns may be held responsible for a portion of the plaintiff’s contributory negligence if the Plaintiff failed to take care for her own safety due to impairment which is the fault of the tavern under the Liquor Licence Act. Liability under s. 39 of the Liquor Licence Act is a statutory liability arises once the factual pre-conditions provided for therein have been found to exist.

This post contribution authored by Tara Pollitt, a lawyer in our office at McCall Dawson Osterberg Handler LLP.

Insurance Success Tip #2 - Use High Deductibles

Let the insurance company take the big risks. You pay for small losses.

$5,000 is the minimum deductible most businesses should have on property insurance. Same for crime insurance, machinery coverage, and the physical damage portion of your automobile insurance.

Most liability insurance policies do not have a deductible. When someone is hurt or you have damaged their property get your insurance company involved soon. The same day the accident occurred is the best approach.

Don't play the dollar swapping game with your insurance company.

Increased Cost of Construction

"are the costs of betterments required by current building codes, as when glazed safety class must be used to replace standard sheet glass."

From "Burnham's Insurance Dictionary" (www.BurnhamSystem.com) Used with permission.

After the fire many business owners are surprised to learn that their insurance will only pay to replace the building that was - not the building that should be.

Current codes and zoning regulations can increase the cost of reconstruction. Adding protection to pay for the increased cost of construction can save you a great deal of anxiety.

-Upgraded sprinkler systems
-Americans with Disabilities compliance
-Life Safety code improvements
-Electrical system upgrades

Ask you agent how much coverage you have for increased cost of construction.

Term life vs. cash value life insurance

If you're single or have no dependents, you probably need little or no life insurance. With a little planning, you can establish a low-risk savings fund to cover funeral costs, and then invest the money you would have paid in insurance premiums.

If you're single or have no dependents, you probably need little or no life insurance. With a little planning, you can establish a low-risk savings fund to cover funeral costs, and then invest the money you would have paid in insurance premiums.

But if anyone depends on your income stream, you need life insurance to protect it. Aim to replace it, but don't think you need to pay a lot for a policy that will give your family a lotterylike payout if you die.

There are two main types of life insurance: "term" and "cash value."

With term insurance, your premium payments are applied entirely to the cost of the insurance, and coverage can easily be dropped when you no longer have dependents. It's a very simple and effective option.

Cash value insurance, meanwhile, encompasses a wide variety of financial products, such as whole life, universal life and variable life. These combine term life insurance with a long-term, tax-sheltered savings plan.

The most important thing to understand about these policies is that they're designed to be held for life. There are usually significant upfront charges associated with setting up the savings plan, investing the money and paying the agent's commission. Even with these charges, tax-sheltered savings can still catch up to taxed investments and begin delivering a real advantage — but that can take 10 to 20 years.

So never opt for cash value insurance without doing a lot of homework. Don't let an aggressive agent sway you with confusing presentations and emotional arguments. Remember that term life can last as long as you want, via guaranteed renewable policies. If you're attracted to the investment portion of cash value insurance, know that you can always buy less-expensive term insurance and invest the difference on your own.

Don't make the common mistakes of buying more insurance than you need, or the wrong kind of insurance. Look up some prices at www.insure.com.

The Motley Fool

Investing in a sure thing: Life insurance

by Parker Leavitt
The Arizona Republic

Selling life-insurance policies on the secondary market is an increasingly popular way for investors to capitalize on one of life's surest events: death.

Investors, including some major players on Wall Street, buy the policies in bunches, pay the premiums and collect millions upon the death of the insured.

First introduced in the late 1990s, the life-settlement industry has swelled to at least a $12 billion market, according to Connecticut-based Conning Research & Consulting Inc.

Several large investment firms, including Goldman Sachs, JP Morgan and Wells Fargo, have experimented with life settlements.

Opinions about the business are diverse, but many experts agree the market is beneficial to both the buyer and seller.

The secondary market allows elderly policyholders who may no longer need life insurance to sell the policy for several times more than the insurance company would pay for a cash surrender.

"What the insurance companies will pay you is a lot less than what the policy is worth," said Alan Rosenfield, managing director of Harmony Asset Management LLC in Scottsdale.

Life-settlement buyouts can reach six figures, and some policies have been sold for over $1 million.

"Given a policy's true value in the secondary market, life settlements offer someone considering surrender a sensible and compelling alternative," said Marc Ruskin, a regional vice president for Life Equity LLC.

But a life settlement may not be appropriate for everyone.

Financial planner Stephen Barnes of Phoenix said he advises nearly all of his clients to hold on to their policies.

"The (life-settlement) industry is largely unregulated, the fees and commissions are obscene, and the rates of return on investment aren't what they used to be," he said.

Seniors must also beware of get-rich-quick schemes.

"There's a dark side of this business that taints the entire industry's reputation," Barnes said.

Ruskin agreed that some have tried to abuse the system.

"It was the Wild West about 10 years ago when this all started," he said.

Now, some of the largest life-settlement providers have joined together to form the Life Settlement Institute, an organization devoted to the prevention of fraudulent or dishonest life-settlement transactions.

Despite perception problems and a general lack of public awareness, some firms have enjoyed rapid growth, even during the recession.

Texas-based Life Partners Inc. increased its revenue from $30 million in 2007 to $103 million during its most recent fiscal year.

And although the tight credit market has hurt some life-settlement companies, Life Partners President R. Scott Peden is confident his company will continue to grow.

"Investors are looking at life settlements as an alternative kind of investment," he said.

Rosenfield said the concept is simple.

"The fact is people will die," he said. "That's one of the few things that you know will happen. The only question is when."

Pharmacy Errors Kill

Medication is engineered to be powerful. Small pills with concentrated ingredients can have a huge effect. 

Usually, these effects are intended to help us. 

But truthfully, we as consumers place an awful lot of faith and trust in the doctors who prescribe and the pharmacists who dispense these medications. These highly trained professionals are all human, and therefore sometimes make errors. These include drug interactions, filling errors and the like.

Their errors can have fatal results.

Consider a pharmacist who reads a  .75 milligram does as 7.5 milligram dose. That is a dose ten times the intended amount!

Or, consider a pharmacy tech who drops the wrong prescription bottle in the patient's bag. The error may be discovered only after the death of the patient. 

Please, check the bottles you or your loved ones receive. If the drug is new, look it up on drug sites and make sure they match the color, size and imprint. Check the match.

Drugs strong enough to require prescriptions can kill. I have seen that in cases I am involved with. 

If you have any questions, ask. Let's help stop the errors.

David B. Peel
dpeel@bigriver.net
www.PeelLawFirm.com



Insurance Success Tip #1 - Bid Regularly

To get the very best premium and the best coverage you must bid your business insurance regularly.

The insurance marketplace is now structure so that insurance buyers who do not regularly bid will pay a "Loyalty Tax." Insurers provide the most aggressive pricing when they think they will lose the account.

Competition gets you the best coverage at the best price.

Violation of Privacy

Violations of privacy become a greater issue almost every day.

Customer lists, private information...

Look to your general liability insurance (GL) for some coverage under the personal and advertising injury section.

Most GL policies will specifically include coverage for "oral or written publication, in any manner, of material that violates a person's right of privacy." There is a standard exclusion for "personal and advertising injury caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict personal and advertising injury."

Beware, some insurers are adding exclusions for damages caused by an invasion of privacy. Review your policy.

Stop the presses! SJC adopts pro rata allocation!

As I discussed here nearly a year ago the United States Court of Appeals certified to the SJC questions regarding allocation. Today the SJC issued its decision in Boston Gas Co. v. Century Indem. Co. The decision is not yet available from the on-line SJC docket. The Westlaw citation is 2009 WL 2184647.

In a nutshell

The court adopted pro rata time-on-the-risk allocation, thereby overthrowing ten years of attorneys and litigants using their best guess that Massachusetts is a joint and several liability state based on a couple of not-very-clear Massachusetts Appeals Court decisions. The court also held that the insured must pay only a proportionate share of a self-insured retention for each triggered policy period.

What pro rata and joint and several allocation mean

In pro rata allocation a long-term loss, such as environmental contamination, is allocated among all insurers who provided insurance covering the time the loss was occurring (or "triggered"), and the loss is frequently allocated to the insured for periods where it had no or insufficient insurance.

In joint and several allocation, one insurer must pay the entire loss up to its policy limit even if there were several insurers on the risk or a period of uninsurance.

The basis for the pro rata decision

The court based its decision on both the policy language at issue and on public policy. In my opinion allocation issues should not be based on policy language because when more than one insurer, or even more than one policy form issued by the same insurer in different years, is involved they may have different policy language which would compel different results; but one loss cannot be allocated in more than one way. Had the court based its decision only on the policy language, it would not be clear that pro rata allocation would apply to other cases.

However, the court also adopted pro rata allocation based on public policy reasons. It stated that joint and several allocation does not "solve the Allocation problem; it merely postpones it." That is only partially correct. In many jurisdictions that have adopted joint and several allocation, an insurer who initially pays the loss may bring a suit for equitable contribution against other insurers to have them contribute their pro rata share to the loss. However, under joint and several allocation there is no contribution from the insured and no suit for equitable contribution can be brought against the insured.

Adoption of time-on-the-risk allocation

The court also adopted the time-on-the-risk method of pro rata allocation. Under that method each insurer pays up to its policy limits in proportion to the number of years it was on the risk. If a loss occurred over ten years and one insurer provided coverage for five years, it would be responsible for fifty percent of the loss up to its policy limits.

The insured will bear its proportionate share of the loss

The court held that the insured will be allocated losses for periods where it was self-insured, uninsured, or insufficiently insured. The court did not address a scenario where an insured had insurance but that insurance is no longer available due to bankruptcy of the insurer, but based on its discussion regarding periods where no insurance was available the court would almost certainly hold the insured responsible for loss during that period.

The insured must pay only a proportionate share of its self-insured retention for each policy period

The court held that the insured must satisfy only a prorated amount of its self-insured retention for each triggered policy period, to be prorated on the same basis as the insurer's liability. "Thus, if the pollution in this case had occurred over the course of a decade, then one-tenth of the total cleanup cost would be apportioned to each policy year and Boston Gas would be responsible for one-tenth of its applicable self-insured retention for each year."

More later

That's it in a nutshell. I'll be out of the office for a while, so you'll be reading some posts about some less earth-shattering decisions. But I will come back to this decision and provide more analysis of it.

As usual, thanks to Mike Tracy of Rudolph Friedmann LLP for bringing this decision to my attention within minutes of it being issued.

HURT on SOMEONE ELSE's PROPERTY- Who's at Fault?

I believe the most persistent Legal Myth is that if you are hurt on someone's property that the landowner is "Automatically Liable."

That is NOT TRUE

It has never been true anywhere.

But, I do think I understand where it came from. If you are at my home, and you trip over your own two feet and break your leg, I am not liable. In other words, nothing I did--or did not do--caused you to fall. But, I have medical payments coverage on my homeowners that may pay medical bills regardless of fault.

So then, your mother hears that her son fell on my property and all his medical bills were paid. Her conclusion is that I was liable, so my homeowners paid. The Myth grows.

But, Homeowners would not, in my example, pay things like pain and suffering, lost wages, etc. Only medical bills would be paid and only to the limit of coverage (usually $5,000.00). 

Another problem arises when the homeowner is clearly at fault, but it was NOT an accident.  Such as if you get into a scuffle during a ball game in the homeowner's yard. If the homeowner breaks your jaw with a punch, that is an intentional act, not an accident. Therefore, homeowners will deny the claim. However, again, they may pay medical bills under medical payments coverage.

Finally, though, lets say that the homeowner left a hole in the dark flower bed and you don't see it and your ankle is broken. That would be an accident, caused by the homeowner and likely covered.  The negligent act was leaving an open hole that was not obvious and created a trap of sorts for visitors.

This is not the only Legal Myth out there, but it seems to be the most pervasive. 

What do you think?





Court of Appeals holds that there is no coverage under claims-made policies unless claims are both made and reported during policy period

In In Gargano v. Liberty Int'l Underwriters, Inc., the United States Court of Appeals for the First Circuit made the obvious ruling that there is no coverage under policies requiring that claims be made and reported during the policy period for a claim that was not both made and reported during the policy period.

The plaintiff was an attorney who had three consecutive claims-made professional liability policies running from September 1, 2004 to September 1, 2007.

The plaintiff was sued in March 2005 for enforcement of an attorney's lien on a worker's compensation claim. (Attorney's liens are filed by attorneys who work on contingency fee cases that are taken over by another attorney. It protects their right to a reasonable fee for the work they did by placing a lien on the attorney's fees eventually received by successor counsel.) He did not report the claim to his insurers until after judgment entered against him in July 2007.

The court held that there was no coverage under the first policy because the claim was not reported during the policy period. It held that there was no coverage under the third policy because the claim was not made during the policy period.

Chronic Pain - Non-Pecuniary General Damages $175,000

Degennaro v. Oakville Trafalgar Memorial Hospital, [2009] O.J. No. 2780 (S.C.J.).

Is this the new high water mark for chronic pain?

"171 I am persuaded that the range for non-pecuniary loss for Ms. Degennaro, urged upon me by Mr. Kwinter, is appropriate. I will award Ms. Degennaro $175,000 for non-pecuniary loss.

172 It is clear that Paul Degennaro and the children have suffered a loss of guidance, care and companionship as a result of the injury to Ms. Degennaro. I will award Mr. Degennaro $65,000 for his claim under the Family Law Act. I will award each child $25,000."

It will be interesting to see if this decision gets appealed or stands.

Why PIP claims are rarely litigated

In my last post I discussed the Salem District Court case of Genest v. Commerce Ins. Co., in which an insurer was held not to have violated Mass. Gen. Laws ch. 93A when it based its denial of a PIP claim on an IME report.

In that case it is worth noting that although 93A damages were denied, the insured was probably awarded attorney's fees pursuant the PIP statute itself. The statute grants attorney's fees if judgment against the insurer enters on a PIP claim.

That is crucial. The maximum actual damages under a PIP claim are $8,000. Very few lawyers are willing to litigate a claim of that size. On a contingency fee claim they simply cannot make back their investment of time, and on an hourly basis the client would end up losing money. The only way such a claim is worthwhile is if an award of attorney's fees is available.

However, under the PIP statute, an insurer can pay a PIP claim at any time up until judgment enters, even after trial has begun, and not have to pay attorney's fees. As Genest illustrates, an insurer can incorrectly refuse to pay a PIP claim without being liable for attorney's fees under 93A.

That is why PIP claims are rarely litigated.

Just Published, 20 Biggest Business Insurance Mistakes - 4th Edition

The fourth edition of my most popular white paper is now available. Thousands of copies have been downloaded and shared. I receive comments from all over the world on my ideas included here.

Some of the info is similar to past editions. Some stuff is new. I have also added an insurance glossary and my article on how to read an insurance policy.

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Comments appreciated and welcome.

Insurance Buyers - This document will give you ideas and hints as to issues you should be discussing with your insurance agent. Many insurance buyers have fount tips here that have saved them thousands of dollars. Feel free to pass this on to other business owners, your attorney, and accountant.

Insurance Agents
- Agents often ask me how to differentiate themselves from competing agents. I counsel agents to increase the value they provide to prospects and clients. Here is a free tool for you to use. Distribute this document to your clients and prospects (naturally, without alteration). Email the document or point people to the webpage.

Insurance Company People - Feel free to tell your agents and marketing people about this white paper. Pass it on.

Definition of Chronic Pain from the Supreme Court of Canada

This is not a new decision but worth re-reading.

"Chronic pain syndrome and related medical conditions have emerged in recent years as one of the most difficult problems facing Workers' Compensation schemes in Canada and around the world. There is no authoritative definition of chronic pain. It is, however, generally considered to be pain that persists beyond the normal healing time for the underlying injury or is disproportionate to such injury, and whose existence is not supported by objective findings at the site of the injury under current medical techniques. Despite this lack of objective findings, there is no doubt that chronic pain patients are suffering and in distress, and that the disability they experience is real. While there is at this time no clear explanation for chronic pain, recent work on the nervous system suggests that it may result from pathological changes in the nervous mechanisms that result in pain continuing and non-painful stimuli being perceived as painful. These changes, it is believed, may be precipitated by peripheral events, such as an accident, but may persist well beyond the normal recovery time for the precipitating event. Despite this reality, since chronic pain sufferers are impaired by a condition that cannot be supported by objective findings, they have been subjected to persistent suspicions of malingering on the part of employers, compensation officials and even physicians." (underlining added)
Nova Scotia (Workers' Compensation Board) v. Martin, [2003] 2 S.C.R. 504 at para. 1 (Gonthier J.).

Insurer did not violate 93A when it relied on IME to deny PIP claim

Massachusetts Lawyers Weekly recently reported on the case of Genest v. Commerce Ins. Co., a Salem District Court case in which an insurer was held not to have violated Mass. Gen. Laws ch. 93A when it failed to pay PIP benefits.

I was unable to obtain a copy of the decision online, so I am relying on the Lawyer's Weekly summary.

The insurer initially denied the plaintiff's $250 claim for PIP benefits, in reliance on an independent medical evaluation report.

The court held that in so doing the insurer did not violate Mass. Gen. Laws ch. 93A, even though judgment eventually entered against the insurer.

The court said, "where an insurance carrier has grounded its denial of a claim upon a legitimate defense and thereafter simply determines to pay a claim (in this case a nominal claim) within thirty (30) days of when the benefits are due and payable (in this instance within thirty (30) days of entry of any judgment), the plaintiff shall not be entitled to G.L. Ch. 93A relief."

Service of out of state defendants in a motor vehicle accident

In my last post I discussed Huggins v. Santos, in which the Massachusetts Appellate Division ruled that service on the insurance company of an out of state defendant is not proper.

In a footnote the court did state how an out of state defendant in a motor vehicle accident claim can be served: pursuant to Mass. Gen. Laws ch. 90 § 3C, service may be made upon the Massachusetts Registrar of Motor Vehicles and mailing a copy of the process by registered mail, return receipt requested, to the defendant.

The Insurance Agent Acid Test

I am often asked what makes a good insurance agent.

Years ago I would go on and on about experience, education, responsiveness, and the like.

Sure, those things are important. However, for an insurance buyer, it comes down to one thing: Are you confident in the agent's abilities to help you in a crisis?

This question is best answered with a virtually fool-proof test. I call it the acid test.

If you knew that your building was going to be destroyed by a conflagration who would you want standing next to you?

Your gut will tell you if you have confidence in your insurance agent.

NURSING HOME NEGLECT & ABUSE

Cases of Nursing Home Abuse and Neglect make me more mad and sad than just about any other cases I handle. 

It has been said that a society can be judged by how well we treat the helpless and the aged. If true, our society is failing.

Over and over, we see some Nursing Homes employ too few folks, and often no care is given to those needing it most.

Bedsores or "pressure sores" range form small red marks, to blister, to craters to actual holes, where you can see the bone and muscle underneath (stage 4). They should not happen and progress to that point!

Check loved ones by looking at their heels (take the socks off!) and having them rolled to see their sacral area. This is the region of the lower back and their bottom. This is a bad spot because fecal waste gets into it. 

If sores are found , photograph them and raise Cain with the staff. In one case, the sores lead to death from sepsis (infection) in less than 9 weeks!

This should not happen. Lawyers and lawsuits will eventually cost the Nursing Homes enough to improve care.  Will it happen into time to protect you?


David Peel
www.PeelLawFirm.com
dpeel@bigriver.net

 

Service of process on defendant's insurance company held insufficient

The Massachusetts Appellate Division held last month that service of process on a defendant in a motor vehicle accident cannot be made by serving the defendant's insurance company. (The Massachusetts Appellate Division hears appeals from the Massachusetts District Court. The decisions of the Appellate Division do not set precedent, and may be appealed the the Massachusetts Appeals Court.)

In Huggins v. Santos, decided on June 17, 2009, Huggins alleged he was injured by Santos in a car accident in Massachusetts in 2004. Santos allegedly lived out of state. The trial court judge allowed Huggins' motion for leave to make service upon Santos by serving Santos's insurance carrier.

After service on the insurer Santos answered the complaint, including an affirmative defense that service was not properly effected and was untimely. Santos then moved to dismiss the case on the grounds of improper service. The court eventually dismissed the action.

On appeal the Massachusetts Appellate Division upheld the dismissal. Huggins argued that Massachusetts Rule of Civil Procedure 4(e)(5) permits a judge to order any means of service on an out-of-state defendant. The court held that there is no authority allowing a defendant to be served through his or her insurance company. The court said, "To argue that such service was proper because the rule permits the court to order service by any means on an out-of-state defendant is to beg both the general question of its propriety and the specific question of whether the method ordered satisfied the very purposes of service of process: to insure a defendant's due process rights by providing notice and an opportunity to be heard."

Is chronic pain a foreseeable injury? (post-Mustapha)

In the recent decision, Degennaro v. Oakville Trafalgar Memorial Hospital, [2009] O.J. No. 2780 (S.C.J.), the Court considered the issue of reasonable foreseeability and chronic pain in the light of the Supreme Court of Canada's comments on this issue in Mustapha, [2008] 2 S.C.R. 114.

Gray J., considering whether chronic pain is a foreseeable injury in light of Mustapha, noted that: "There is obviously a subtle distinction between a person of less than ordinary fortitude who suffers damage that is not foreseeable, and a person of ordinary fortitude who suffers damage that is more serious than expected."

In Degennaro the plaintiff developed chronic pain after an injury that resulted in a fractured sacrum. The fracture healed but her pain got worse. There was no objective reason for the continuing and worsening pain. The eventual conclusion of her treating physicians was that the plaintiff had developed fibromyalgia. Although it was in dispute at the trial, the Court concluded that the chronic pain was caused by the same fall that had resulted in a fractured sacrum.

The Court then had to consider whether the chronic pain was foreseeable. This is what Gray J. wrote at paras 158-163.

158 In Mustapha, supra, the Supreme Court of Canada analyzed the issue. In that case, the Court held that it was not reasonably foreseeable that the plaintiff would suffer serious mental injury as a result of seeing flies in a bottle of water that he was about to install for a customer.

159 At para. 14 of her judgment, McLachlin C.J.C. stated that a plaintiff is to be considered objectively, not subjectively. Thus, a plaintiff is not to be considered in the context of his or her own personal makeup, which may give rise to the specific injury suffered, but rather objectively. That is, one must ask what a person of ordinary fortitude would suffer.

160 At para. 16 of her judgment, McLachlin C.J.C., in a passage that has some significance for this case, stated:

Once a plaintiff establishes the foreseeability that a mental injury would occur in a person of ordinary fortitude, by contrast, the defendant must take the plaintiff as it finds him for purposes of damages. As stated in White, at p. 1512, focusing on the person of ordinary fortitude for the purposes of determining foreseeability, "is not to be confused with the 'eggshell skull' situation, where as a result of a breach of duty the damage inflicted proves to be more serious than expected". Rather, it is a threshold test for establishing compensability of damage at law.


161 In my view, it is foreseeable that chronic pain may result from a physical injury. While the actual cause of chronic pain is not known, it is known that some people will develop chronic pain after physical trauma. Thus, chronic pain is foreseeable as falling within a range of consequences that may flow from a physical injury. This is a foreseeable consequence in a person of ordinary fortitude. Thus, in my view, the defendants must take the plaintiff as they find her. As noted by McLachlin C.J.C. at para. 16 of Mustapha, supra, this is simply a case where the damage inflicted has proven to be more serious than expected.

162 There is obviously a subtle distinction between a person of less than ordinary fortitude who suffers damage that is not foreseeable, and a person of ordinary fortitude who suffers damage that is more serious than expected. However, in view of the analysis in Mustapha, the distinction is real and must be respected. I have no doubt that Ms. Degennaro falls into the category of a person who is a person of ordinary fortitude who has suffered damage that is more serious than expected.

163 For the foregoing reasons, the chronic pain suffered by the plaintiff, Ms. Degennaro, was a foreseeable consequence of the incident that occurred in May, 1999, and the defendants must compensate her for it.

Division of Insurance reports that car insurance rates have fallen 8 percent

According to this article in The Boston Globe the Divison of Insurance reports that car insurance rates have fallen eight percent since deregulation began a little more than a year ago.

The article suggested that this statistic be taken with a grain of salt, noting that the report came out just before the July 4th weekend, suggesting that the Commission was hoping it would not be closely scrutinized.

On the Internet

Here are some links to a few Canadian legal blogs that I've been reading lately and I've found them to be helpful. Take a look but I add the caveat that I have nothing to do with these websites - so read at your own risk!!

http://www.thecourt.ca/

http://www.slaw.ca/

http://www.cavanaghwilliams.com/blawg/

Worker's Compensation - 2

Further to my last post, the question often is whether a worker is in the course of employment or not.

For example, if a worker is on a smoke break at work when they get injured, is this an “injury by accident, arising out of and in the course of his or her employment”? Is this employee entitled to benefits from the Worker’s Compensation fund or is the worker able to sue?

There are several decisions from the Workplace Safety and Insurance Appeals Tribunal (“WSIAT”), going back 15 to 20 years ago, in which the Tribunal held that workers who drive around most of the day as part of their employment and who have an accident while on a coffee break, stopping for lunch or running an errand not far off their scheduled route, do not create a “distinct departure” from their employment activities. Therefore, the accident was held to fall within the parameters of Section 13 of the WSIA, 1997, “an accident arising out of and in the course of employment”. The WSIAT ruled that the tort action was barred. These are cited at WSIAT decisions 351/90, 62/94 and 669/89.

In another case found at WSIAT decision 901/95, at paragraph 44, the tribunal found that a plaintiff who slipped and fell when he was going into a donut shop was engaged in a work-related activity that was reasonably incidental to his employment. In that instance, the plaintiff was a salesman and often used the donut shop for filling out paper work because he did not have an office of his own. He also often met clients at the donut shop.

The test used by the WSIAT is whether the personal injury in a work-related activity was “reasonably incidental” to the injured person’s employment. The WSIAT, in their decision of 901/95, also stated that they were persuaded that the plaintiff was engaged in a work-related activity that was reasonably incidental to his employment on the basis that the timing, duration, and potential cancellation of each break was determined by the requirements of the plaintiff. In other words, the plaintiff, as a salesman, was self-directed and there was not a bright line to distinguish between when he was on a break or when he was working in the donut shop.

In a more recent decision, the WSIAT, at decision 285/05, affirmed the work-relatedness test when deciding that an employee’s right of action had been taken away by the WSIA, 1997 when the employee slipped and fell in a parking lot of an airport while on a business trip.

The WSIB has an Operational Policy Manual which contains policies related to this issue. Policy document 15-02-02, which applies to all decisions made on or after July 1, 1990, states that a personal injury by accident occurs in the course of employment if the surrounding circumstances relating to place, time and activity indicate that the accident was work-related. Further, policy document 15-03-03, applicable to all decisions made on or after June 1, 1989, states that a worker is considered to be in the course of employment on entering the employer’s premises but that the “in the course of employment” status ends on leaving the employer’s premises, unless the worker leaves the premises for the purposes of employment. These policies seem to be in conformity with the WSIAT’s decisions.

5 LEGAL RESOLUTIONS

Legal Lessons

 

FIVE LEGAL RESOLUTIONS

  

Most folks have given up on their New Year's resolutions by February.

 

So, here are few Legal resolutions that you can do today, to help yourself and your family:

 

1.    Make a videotape of all of your household goods. If you suffer losses due to tornado, fire, theft or earthquake (optional coverage) you can easily fill out claim forms by watching the video in the apartment or hotel your insurance company places you in.

 

2.    Buy more UM coverage. UM stands for Uninsured/Undersinsured Motorists coverage. On your car, you should carry at least $100,000.00 of this coverage. It is very cheap compared to what you may receive. It only pays your family or those in your car if they are injured or killed by an unknown, undersinsured or uninsured motorist. 

 

3.    Check your credit. You can do this for free, once per year per agency at www.annualcreditreport.com. This will help you spot identity theft and open cards you may have forgotten about.

 

4.    Check your house and land for hazards. Are their rotten trees overhanging your driveway? They kill people every year. Do you have a good fence around your pool? Is your dog dangerous or improperly secured?  Are your steps solid and stair railings tight? Are there hard to see holes or trip hazards in your yard? Is there plenty of lighting available at night? If you have cattle, are your fences in good shape without overhanging limbs or unlocked gates? 

 

5.     Do you have life insurance? Many do not. It is common for grief stricken widows to have to work two jobs to pay the funeral off. Is that your plan for your loved ones? Buy term insurance.

 

These few pointers may make a real difference for you this year. And, they are not nearly as hard as a resolution to lose some weight.


Worker's Compensation in Ontario and Restrictions on the Right to Sue an Employer

The Workplace Safety and Insurance Act, 1997 governs the Ontario workers’ compensation system.

Fundamental to this system is a compromise in which workers give up the right to sue for their work-related injuries, irrespective of fault, in return for guaranteed compensation for accepted claims.

Employers receive protection from lawsuits in exchange for financing the program through premiums.

Employees cannot sue employers or most other employers for injuries occurring during employment, in most circumstances.

This system of collective liability provides compensation for injured workers and their families, while spreading individual costs among employers.

It means that if an employee commences a lawsuit against its employer or other employer, that employer can have the lawsuit dismissed.

Here is how it works:

Section 13(1) of the WSIA, 1997 states that a worker who sustains a personal injury by accident, arising out of and in the course of his or her employment, is entitled to benefits under the insurance plan.

Section 28 of the WSIA, 1997 provides that a worker employed by a Schedule 1 employer is not entitled to commence an action against any Schedule 1 employer (or a Director, Executive Officer or a worker employed by any Schedule 1 employer) in respect of the worker’s injury. This protection from lawsuits is the trade-off for the compensation injured workers receive.

Section 27 of the WSIA, 1997 states that Section 28 applies with respect to a worker who sustains an injury that entitles him or her to benefits under the insurance plan. Therefore, this prevents workers who are entitled to benefits under the insurance plan from suing another employer who is also within the same Schedule 1.

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MSAD 52, Turner, Maine

Small Claims Court - $25,000 Limits

On January 1, 2010, the monetary jurisdiction of Small Claims Court in Ontario will be raised from $10,000 to $25,000. The limit had not changed since 2001 when it was increased from $6,000 to $10,000.

The question I have been wondering is, what will happen to cases started prior to January 1, 2010, but which claim between $10,000 and $25,000? If you start a case before Jan. 1 for $25,000, will it automatically be transferred to Small Claims Court after that date?

The answer seems to be no.

Section 23(2) of the Courts of Justice Act states:

"An action in the Superior Court of Justice may be transferred to the Small Claims Court by the local registrar of the Superior Court of Justice on requisition with the consent of all parties filed before the trial commences if,

(a) the only claim is for the payment of money or the recovery of possession of personal property; and

(b) the claim is within the jurisdiction of the Small Claims Court."

It seems that this rule will apply for transfers after January 1, 2010.

In the absence of consent among the parties, a change will require a motion to the Superior Court of Justice.

Why would a party prefer the Superior Court of Justice to the Small Claims Court? One reason would be the discovery procedures available to the parties in Superior Court which are not available in Small Claims Court, such as examinations for discovery and affidavits of documents. Small Claims Court only requires parties to produce documents upon which it intends to rely at trial and a list of proposed witnesses and other persons with information about the matter at issue. This is a significant difference.

Another reason might be the costs rules which are limited in Small Claims Court to 15% of a claim (this can be doubled if a party beats at trial its own offer to settle, in certain circumstances). Of course this is more restrictive than the costs that are available to a successful party in a Superior Court action.

The consequence to a plaintiff however for failing to transfer a proper case to the Small Claims Court may be an order that the plaintiff not receive any costs. See Rule 57.05 of the Rules of Civil Procedure.
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