2019 #6
This Q asks about mental & behavioral impairment but the second case study they provide in the solution (aviva v pastore) as about a physical injury, am I missing something? where is the mental portion to the pastore case?
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This Q asks about mental & behavioral impairment but the second case study they provide in the solution (aviva v pastore) as about a physical injury, am I missing something? where is the mental portion to the pastore case?
Comments
The question asks: "Discuss the treatment of mental and behavioural impairment for the purpose of determining catastrophic impairment under SABS in Ontario citing any relevant precedents to support the conclusion drawn".
The issue of the case was whether showing a marked impairment in only one of the four areas of functioning was enough to qualify for a catastrophic impairment designation under SABS. Note that all four of these categories are for assessing mental and behavioural impairment. For assessing physical impairment, different criteria is used (whole person impairment of 55% or more + special cases).
I acknowledge that the battle cards for Aviva v. Pastore do not directly state the involvement of mental & behavioural impairment, which we can work on addressing.
In relation to Aviva v Pastore case, I'm getting confused on the case, and I'm getting waaay too much into weeds, so just for curiousity
In the BA webpage, it states "Definition of Class 4 Impairment: marked impairment significantly impeding useful functioning in at least 1 of: (DSCW)". However, my understanding is that "class 4" is a severity classification. And to satisfy SABS "catastrophic impairment" you would need class 4 on 3 of the DSCW, or class 5 on 1 of the DSCW. This seem to be support on SABS website? https://www.ontario.ca/laws/regulation/100034
Given #1 is correct, why did supreme court side with Pastore?
Edit: it appears that's the newer regulation effective 2010, this case was earlier. It make sense they sided with Pastore according to pre-2010 regulation because of the wording:
https://www.ontario.ca/laws/regulation/960403
Just saw your edit.
It’s easy to get caught up in the legal details of these cases, but as actuaries, not lawyers, it’s most effective to take a high level approach. The key is to understand the core issue, the basic facts, the court’s ruling, and most importantly, how that ruling impacts the insurance industry. This allows us to focus on what matters most from an actuarial and regulatory perspective without getting lost in legal nuance.
It sounds like you have a good handle on this case now though!