Legal Expense
Legal Expense Coverage Specifications Executive Summary
The Power Workers’ Union Protection Plan provides reimbursement of legal expenses incurred in defending you in relation to family law matters and against most criminal charges and civil law suits.
What types of legal actions are covered?
- Suits heard in courts such as the Superior, Provincial and Small Claims Courts
- Other civil suits
- Family law (e.g. divorce, separation).
- Criminal charges, including impaired driving charges.
- Charges related to Provincial Offences, e.g. Highway Traffic Act offences.
What types of legal expense are covered?
- Defence costs, including lawyers’ fees and disbursements made to defend you in a legal proceeding (including matrimonial proceedings where the member is a defendant)
- Costs (including disbursements) and legal fees involving a counterclaim (including third party claims) brought directly as part of the defence of a claim against the member.
- Mutual separation or mutual divorce agreement or matrimonial matters (i.e. both parties have agreed to terms of the separation or divorce and are simply seeking court approval of same):
- In respect only of mutual separation or mutual divorce agreements or matrimonial legal proceedings only where the separation or divorce leading to the legal proceeding occurred on or after February 26, 2011, the member is entitled to coverage of costs and defence costs if he or she is or would be either the plaintiff or defendant in the proceedings
- In respect only of separation or mutual divorce agreements or matrimonial legal proceedings where the separation or divorce leading to the legal proceeding occurred before February 26, 2011, the member is entitled to coverage of costs and defence costs only if he or she is the defendant or respondent proceedings.
Can I choose my own lawyer to defend me?
- Yes, you can, subject to the approval by the Program Manager.
- You MUST contact the Call Centre (1-877-393-0338) at the outset of your case to arrange for approval of your lawyer and to arrange for payment of fees. You must NOT pay any money to your lawyer yourself. ALL billing and payment will be carried out between the lawyer and the PWUPP.
In CRIMINAL MATTERS, Addario Law Group in Toronto regularly provides advice and representation for the Union and its members. Frank Addario and Bill Thompson represented the PWU member charged and acquitted in the Barrett Chute incident. Their law firm is pre-approved by the Program Manager. Their contact information is as follows:
Bill Thompson-Office: (416) 649-5057; Cell (289) 314-6167
Samara Secter: (416) 649-5063; Cell (647) 289-5933
Lynda Morgan: (416) 649-5051
Wes Dutcher-Walls: (416) 640-1591
Frank Addario-Office: (416) 649-5055; Cell (416) 720-9824
In addition, other lawyers, who acted on behalf of the defendants or witnesses in the Barrett Chute criminal case, are as follows:
Mark Ertel (Ottawa) – Office (613) 236-0535; Cell (613) 299-0350
Patrick McCann (Ottawa) – Office (613) 236-1410; Cell (613) 863-1410
In CIVIL MATTERS, the following law firm has been pre-approved and regularly does civil work for the PWU:
Paliare Roland Rosenberg and Rothstein
155 Wellington Street West, 35th Floor
Toronto ON M5V 3H1
Canada
For assistance and referral to the appropriate lawyer, please contact:
Deanna Watters, Law Clerk to Ian Roland
Tel: (416) 646-7429; Fax: (416) 646-4301
In her absence, please contact the following:
Parlet Blake, Assistant to Ian Roland
Tel. (416) 646-7419; Fax: (416) 646-4301
email: parlet.blake@paliareroland.com
What types of legal expense are NOT covered?
Legal fees are only covered if the proximate cause is on or after the LATER of the inception date of the program, being February 26th, 2007 or the date you became an eligible PWUPP member. Even if your bills are incurred after this date, the Program will not cover a claim if the criminal act, negligence, or other events (which necessitated the legal fees) occurred before this date.
- Costs other than legal defence costs. This means that if you start a law suit against someone else (including a family claim against a spouse), your legal fees for that suit are NOT covered. Legal defence coverage protects you against the cost of defending yourself against an eligible claim made against you. The only exception to this is in the case of mutual separation or mutual divorce agreements or matrimonial legal proceedings:
- In respect only of mutual separation or mutual divorce agreements or matrimonial legal proceedings commenced on or after February 26, 2011,the member is entitled to coverage of costs and defence costs if he or she is or would be either the plaintiff or defendant in the proceedings. Proceedings are “mutual” only if both parties have agreed to all terms of the separation or divorce prior to the commencement of the proceedings.
- However, for mutual separation or mutual divorce agreements or matrimonial legal proceedings commenced prior to February 26, 2011, the member is only entitled to coverage of costs and defence costs only if he or she is the defendant or respondent proceedings.
- Expenses that are predictable or that you choose to incur – e.g. wills, powers of attorneys, real estate legal fees, etc.
- Costs to sue a third party, except for a counterclaim brought directly as part of the defence of a claim against the member.
- Damages, judgments or settlements of any kind.
- Fines, penalties of any kind.
Important Restrictions
Matrimonial Claims
- Coverage for matrimonial claims begins 365 days after February 26th, 2007 or the date you become a union member, whichever is later.
- If you were a PWU member on February 26th, 2007, you will be covered as of February 26th, 2008.
- If you became a member after February 26th, 2007, you will be covered for matrimonial claims 365 days after your union membership began.
- Only the union members are covered for matrimonial claims. There is no coverage or benefit available for union members’ spouses or other family members, unless the spouse is also a member of the union.
- Reimbursement of expenses related to family law and matrimonial law are limited to $3,500 for any one claim, to a maximum of $3,500 per Program period. The most that can be paid is also $3,500 for any one spousal relationship (member’s total limit per any one spousal relationship).
Criminal Charges of Any Kind
- Fees and disbursements covered to the later of the point of acquittal or conviction.
- Reimbursement of expenses for the following will be subject to certain sub-limits:
- driving while impaired
- driving with a blood alcohol level exceeding the legal limit
- failing or refusal to provide a breath sample
- No coverage for parking tickets. Also note that a $500 deductible applies for charges under the Ontario Highway Traffic Act (or equivalent provincial legislation) where the maximum penalty or the charge does not include imprisonment. If the maximum penalty for such a charge includes imprisonment, there is no deductible.
Business Related Claims
- Legal actions arising out of your full time, part time or casual business activities (e.g. if you do part time contract work) are not covered. Any claims or legal proceedings relating to your contract of employment are also not covered.
Coverage Limits
- The Program pays only up to a maximum of $50,000 for all legal proceedings arising out of any one occurrence.
- The maximum payable over the course of any Program period to any individual union member and his/her covered family members is $50,000.
- This $50,000 annual limit is eroded by any claims payments to you or covered members of your family.
Detailed Summary
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Coverage Period/Program Period |
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Coverage is continuous unless the Power Workers’ Union or the Program Manager cancel. |
Limits |
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The maximum the Program will pay in each calendar year is $50,000, regardless of any other limits stated.
Limits will not be increased by subsequent actions, or counter claims relating to the same occurrence. The maximum combined limit available is $50,000 for an occurrence that leads to both a civil and criminal action, counterclaims or appeals.
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What is Covered? |
But all claims are covered only if the criminal acts, negligence, or other events or occurrences (which necessitated the defence, and/or legal bills) occurred on or after February 26, 2007. |
See the section below on “What is Not Covered” for further details. |
What are Criminal or Statutory Charges? | These are offences under the Criminal Code of Canada, The Controlled Drugs and Substances Act, and any other provincial or federal laws which prescribe punishable offences. | Most criminal charges are covered. |
What kind of Legal Expenses are Covered? |
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Coverage Territory | Canada only. | The claim or legal proceeding must be brought against you, in Canada in respect of an occurrence that took place in Canada. |
Deductible | Nil, except that for charges under the Ontario Highway Traffic Act (or equivalent statutes in other provinces) where the offence charged has a maximum penalty that does not include imprisonment, a $500 deductible applies. | |
What do I do if I find out about a claim or legal proceeding? | If you are covered by this Program, once you are aware of an event that results in a claim or legal proceeding – or that might lead to a claim or legal proceeding – you must:
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What Happens Next? |
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You can retain your own lawyer or use the recommended counsel from the PWUPP claims reporting. If you select your own lawyer, the Program Manager has the right to reject your choice and make you select someone else, on reasonable grounds. |
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You must provide a complete and truthful account of all facts and provide all relevant documents and other evidence, attend meetings, and do whatever else is reasonably asked of you. | |
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The Appointed Representative can refuse to give the insurer certain information. You cannot refuse such requests. | |
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Submit your claims to the Program Manager, do not pay them yourself or agree to pay them. The Program Manager will pay your legal expenses in accordance with the conditions in the section below entitled “How are Expenses Approved by the Insurer?”. | |
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If the Program Manager is not notified, they can refuse to pay further legal expenses. | |
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How are Expenses Approved by the Insurer? | The Program Manager will pay all legal expenses provided that they are covered by this Program, and:
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The Program Manager agrees to pay for your legal expenses if they are covered by the Program (in other words not excluded) and they are reasonably incurred.
If the anticipated expense exceeds $3,500 the Program Manager requires you or your lawyer to submit a legal expense budget for pre-approval. |
What Happens if I have a Disagreement with the Program Manager? | The decisions of the Program Manager are final. | |
Appeals |
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Other Conditions on Coverage |
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This Program is only effective once you have exhausted the limits of the other legal expense insurance. |
What is not Covered? |
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You have to wait until you have been covered by the Program for more than a year, before you can claim for divorce or matrimonial matters. |
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Business activities are excluded including any claims or legal proceedings relating to your contract of employment. | |
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You have to wait until you have been covered by the Program for more than a year, before you can claim for divorce or matrimonial matters. | |
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You are not covered for suits against the PWU or other people covered by this Program (union members and their spouses, children) except for legal expenses related to divorces and other matrimonial matters. | |
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