LAWS23078-Special Topic in Paralegal

You are a licensed paralega and work for a personal injury firm, Sheridan Paralegal Professional Corporation located at 101 – 1234 South Street, Brampton, Ontario L2L 2L2, PO Box12, tel: 905-555-1313, fax: 905-555-1414. Use your Sheridan Outlook email address

On January 5, 2020, a client, Elliot Blackburn, was involved in a motor vehicle accident in the intersection of Steeles Avenue West and McLaughlin Road in Brampton. He was travelling eastbound at the speed limit in the curb lane on Steeles Avenue when a car travelling westbound on Steeles Avenue West turned left (to go southbound on McLaughlin Road) in the intersection directly into the path of Elliot’s vehicle. The collision was severe and Elliot’s airbag was deployed. Emergency services were called, and an ambulance took Elliot to Brampton Civic Hospital. The driver of the other vehicle was charged with careless driving under the Highway Traffic Act. Elliot was not charged. At the hospital, it was determined that Elliot suffered whiplash, a herniated back disc, a fractured right wrist (he is right-handed), a mild concussion, and soft tissue injuries.

 

Elliot notified his insurance company of the accident on January 6, 2020. His insurance company details are as follows: Mega Insurance Company, 300-1234 Willow Avenue, Mississauga, Ontario L3L 3L3 tel: 905-555-1515, fax: 905-555-1616. The policy is in his partner’s name – Jennifer Blackburn, policy number JK3Y49321. Jennifer did not purchase additional optional benefits. Mega Insurance assigned claim number 397349286 to the file. The adjuster is Cosmo Kramer (telephone ext: 204, email: . Mega Insurance sent Elliot the Application for Accident Benefits (OCF-1) form which he completed on his own and sent to Cosmo Kramer on January 31, 2020 along with the Treatment Confirmation Form (OCF-23). At Mega Insurance’s request, he also had a Disability Certificate (OCF-3) completed by his doctor and submitted it by the date requested.

 

Elliot works as a registered massage therapist and although he was in good physical condition before the accident, the injuries prevented him from returning to work. He spent several weeks at home recuperating and attending physiotherapy with Morgan Sandford, a physiotherapist. He tried to return to work part-time in early June but was not able to do so. He told Cosmo Kramer that he had tried returning to work without success.

 

In April, Mr. Kramer called Elliot and asked him to submit an updated medical report of his condition. He went to his doctor, Dr. Andrews, who provided a report indicating that Elliot continued to suffer the effects of the soft tissue injury but that the whiplash and herniated disc was beginning to show improvement and he needed to continue physiotherapy. Mega Insurance interpreted the report to mean that Elliot was no longer “unable to perform the essential tasks of employment”. He received a letter on April 21, 2020 indicating that his income replacement and medical benefits were terminated effective April 24, 2020. He called Cosmo Kramer and asked if Mega Insurance was prepared to reconsider the decision and was told no. Mr. Kramer did not ask Elliot to go for a further medical examination but he visited Dr. Andrews again on April 27, 2020 who confirmed by letter that his injuries had not healed sufficiently to return to work. There is no internal dispute resolution process at Mega Insurance.

 

Elliot has retained Sheridan Paralegal Professional Corporation to appeal the termination of benefits. He has brought the following documents to support the appeal:

 

1. Dr. Andrews report dated January 28, 2020

2. Dr. Andrews report dated April 13, 2020

3. Morgan Sandford, physiotherapist, report dated May 4, 2020

4. Income tax return for 2019

5. Last pay slip before the accident dated December 31, 2019

6. Physiotherapy receipts dated April 28, 2020, May 5, 2020, May 12, 2020, May 26, 2020, June 9, 2020, June 23, 2020, July 7, 2020, July 21, 2020 and August 4, 2020 totaling $900.

 

Elliot does not have a summary of benefits paid by Mega Insurance Company which you will need to request as it is a key document which you will rely on at the hearing of the appeal. He had been receiving $400/week in income replacement since January 13, 2020 and had his physiotherapy costs covered in full (valued at $100/week. Mega Insurance has paid out $1,900.00 for physiotherapy between January 13 and April 24, 2020). There is no dispute that the injuries fall within the Minor Injury Guidelines (MIG). It is your client’s position that the insurer has unreasonably held or delayed the payment of benefits. He wishes to claim interest on the income replacement but not on the medical benefits.

 

Elliot lives at Unit 21-456 Franklin Corner, Brampton, Ontario L1L 1L1. His date of birth is January 1, 1975. His preferred language of communication is English and he wishes to communicate by email His telephone number is 905-555-1212. He is not mentally incapable and neither he nor any of his witnesses require any accommodation to participate in a hearing. The witnesses at the hearing will be himself as well as his doctor and his physiotherapist.

 

Prepare the following documents:

(a) Application by an Injured Person

(b) a letter to Mega Insurance Company serving the application

(c) a Certificate of Service of the application on Mega Insurance

(d) a letter to the LAT filing all necessary material

 

You will not be able to “sign” the form; however, you must indicate the names of the individuals who would be signing and the date in the correct field. The application would be signed by Elliot and yourself as his representative on October 19, 2020. You will serve it by regular mail and you will prepare the certificate of service on October 20, 2020. The application fee will be paid by bank draft as you will be mailing it to the LAT.  

 

For all parts of Assignment #2, please see the attached rubric for details on how this assignment will be evaluated.

 

Course learning outcomes

 

This assignment corresponds to the following learning outcomes identified in the Sheridan Course Outline for LAWS23078 Special Topics in Paralegal Practice:

 

1. Interpret legislation governing selective administrative bodies.

 

2. Research the practice, procedure and process relating to proceedings before selective administrative boards and tribunals.

 

3. Prepare persuasive application and response material relating to a variety of administrative proceedings.

 

4. Draft correspondence to parties for a variety of purposes.