D. Gregory Flude

The applicant sought a determination that she sustained a catastrophic impairment due to a 2016 motor vehicle accident, claiming various statutory accident benefits.

The respondent argued her psychological condition was pre-existing and not accident-related.

The Tribunal found the applicant sustained a Class 4 Marked impairment in social functioning and adaptation, satisfying the catastrophic impairment definition.

The Tribunal awarded partial attendant care benefits, costs for an attendant care assessment and a cognitive screen, and interest, while dismissing claims for case management, occupational therapy, a document review fee, and a special award.

The applicant insurer sought repayment of $41,597.02 in statutory accident benefits paid to the respondent, alleging she fraudulently misrepresented her inability to work and need for attendant care.

The respondent, a personal support worker, had signed a statutory declaration and pleadings in a separate lawsuit admitting she provided and was paid for personal care services to a third party during the same period she received income replacement and attendant care benefits.

The Tribunal found the respondent's evidence at the hearing lacked credibility and concluded she willfully misrepresented her ability to earn an income and her need for attendant care.

The respondent was ordered to repay $23,600 in income replacement benefits and $5,970.92 in attendant care benefits, plus interest, but was not required to repay medical and rehabilitation benefits.

The insurer's request for costs was denied.

The respondent insurer brought a preliminary issue motion arguing that the applicant was barred from claiming a physiatry assessment because the expense would be incurred more than 260 weeks after the motor vehicle accident, pursuant to s. 20 of the Statutory Accident Benefits Schedule.

The Tribunal dismissed the motion, finding that the applicant had appealed the denial within the two-year limitation period under s. 56.

The Tribunal held that interpreting s. 20 as an absolute bar would lead to absurd consequences, effectively reducing the appeal period by the time required to process a claim.

The matter was ordered to proceed to a hearing on the substantive issues.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and a medical benefit for physiotherapy.

The respondent denied the claims, arguing the applicant's injuries were predominantly minor and that he failed to meet the test for a non-earner benefit.

The Tribunal dismissed the application, finding the applicant failed to comply with requests for medical documentation under s. 33 of the Schedule and failed to submit a properly signed disability certificate in a timely manner.

Furthermore, the Tribunal found the applicant was not truthful with assessors regarding his extensive pre-existing chronic pain conditions, drawing an adverse inference from his failure to produce family doctor records.

The Tribunal concluded the applicant did not suffer a complete inability to carry on a normal life and failed to prove his injuries warranted treatment beyond the $3,500 Minor Injury Guideline limit.

The appellant appealed a Notice of Proposal to Refuse a Registration issued by the Registrar under the Condominium Management Services Act, 2015.

The parties agreed to resolve the matter without a hearing.

The Licence Appeal Tribunal issued a consent order disposing of the appeal, under which the appellant withdrew his application for a General Licence and acknowledged he is prohibited from providing condominium management services.

The applicant sought a non-earner benefit following a motor vehicle accident.

The respondent insurer raised a preliminary issue that the applicant was barred from proceeding because she failed to cooperate during an insurer's examination.

The Tribunal found insufficient evidence of a deliberate failure to cooperate and allowed the application to proceed.

On the substantive issue, the Tribunal applied the Heath test and found a total lack of cogent evidence to support a finding that the applicant suffered a complete inability to carry on a normal life.

The application was dismissed.

The appellant appealed a proposal by the Registrar to refuse to renew his registration as a motor vehicle salesperson under the Motor Vehicle Dealers Act, 2002.

The appellant admitted to forging bills of sale and submitting false documents to Service Ontario to transfer two vehicles on behalf of his father, claiming he was justified due to a dispute with another dealer.

The Tribunal found that the appellant's admitted misconduct provided reasonable grounds for belief that he would not carry on business in accordance with law and with integrity and honesty.

The Tribunal concluded that the public interest could not be adequately protected by granting registration with conditions, as the appellant failed to accept responsibility and viewed his illegal actions as justified.

The Tribunal directed the Registrar to carry out its proposal to refuse the renewal.

The appellant sought an extension of time to appeal a motor vehicle impoundment under the Highway Traffic Act.

The vehicle was impounded because the appellant was driving without an ignition interlock device, a condition imposed following a 2012 impaired driving conviction in Ontario.

The appellant filed the appeal 35 days late, arguing he was incarcerated and believed his unrestricted Quebec licence superseded the Ontario condition.

The Licence Appeal Tribunal applied the four-part test for extending time and denied the motion, finding the delay was lengthy, the Registrar would be prejudiced, and the proposed grounds of appeal lacked merit.

The appellants appealed a Notice of Proposal by the Registrar, Motor Vehicle Dealers Act, 2002, to revoke their registrations.

The parties reached a settlement and requested a Consent Order disposing of the proceeding without a hearing.

The Licence Appeal Tribunal ordered the Registrar not to carry out the Proposal and directed the registration of the corporate appellants subject to strict conditions, including maintaining books and records, discharging encumbrances within 10 days, prohibiting consignment trades, limiting deposits to $10,000, and providing irrevocable Letters of Credit of $30,000 each to the Motor Vehicle Dealers Compensation Fund.

The respondent insurer brought a preliminary issue motion to strike the applicant's claim for statutory accident benefits, arguing she was not involved in the subject motor vehicle accident.

The applicant claimed she was inside a restaurant when a vehicle crashed into it, causing her injuries.

The Tribunal found the applicant's evidence, including contemporaneous photographs of the accident scene and physical injuries consistent with her account, established on a balance of probabilities that she was involved in the accident.

The respondent's motion was dismissed.

The appellant appealed a Notice of Proposal to Review an Application for a Liquor Licence for an outdoor boulevard patio.

At the outset of the hearing, the parties resolved the issues on consent.

The Tribunal directed the Registrar to issue a consume on premises licence for the patio, subject to conditions including a capacity of 60 persons, operating as a restaurant rather than a nightclub, and closing by 11:00 p.m.

The appellant appealed the Registrar's proposal to refuse his registration as a real estate salesperson under the Real Estate and Business Brokers Act, 2002.

The parties reached a settlement and requested a consent order.

The Licence Appeal Tribunal ordered that the appellant's registration be accepted subject to numerous conditions, including quarterly reporting on trades and consumer proposal payments, and successful completion of compliance courses.

The applicant sought medical and rehabilitation benefits following a motor vehicle accident.

In a prior decision, the Tribunal found her injuries were predominantly minor and subject to the $3,500 limit, which was fully expended.

The applicant submitted further treatment plans, and the respondent brought a motion to dismiss the application on the grounds of res judicata and abuse of process.

The Tribunal held that res judicata applies to Schedule proceedings, though an applicant may bring forward evidence of recent deterioration.

Finding no fresh evidence of recent deterioration that would lift the applicant out of the minor injury provisions, the Tribunal dismissed the application.

The respondent insurer brought a motion under s. 55 of the Statutory Accident Benefits Schedule to bar the applicant's proceeding for attendant care benefits, alleging she failed to attend three insurer's examinations (IEs).

The Tribunal found that the applicant only failed to attend one properly scheduled IE, as the respondent had cancelled the other two.

Although the notice for the missed IE contained sufficient medical reasons, the Tribunal exercised its discretion under s. 55 to permit the application to proceed, noting the applicant had since been deemed catastrophically impaired and was willing to attend rescheduled IEs.

The Tribunal ordered a timetable for the applicant to attend an IE rather than barring or staying the application.

The appellant appealed the Registrar's proposal to attach conditions to his registration as a real estate salesperson under the Real Estate and Business Brokers Act, 2002.

The parties resolved the issues in dispute and requested a consent order disposing of the proceeding without a hearing.

The Licence Appeal Tribunal issued the consent order, attaching the agreed-upon conditions to the appellant's registration for a period of one year.

The appellant home builder brought a motion to strike a Notice of Proposal issued by the Registrar as an abuse of process.

The Notice proposed adding a condition to the appellant's licence requiring an employee to complete a customer service course, which the employee had already completed by the time the appellant notified the Registrar.

The Tribunal dismissed the motion, finding no abuse of process because the Registrar was unaware of the course completion when it issued the Notice and had a public protection mandate to proceed with a hearing on the suitability of the condition.

The applicant and respondent both requested a partial reconsideration of a Licence Appeal Tribunal decision regarding statutory accident benefits following a motorcycle accident that resulted in a catastrophic impairment.

Both parties argued that the initial decision lacked adequate reasons for its findings on attendant care benefits, housekeeping and home maintenance, home modification, and provider mileage.

The Vice-Chair agreed, finding that the original decision's failure to tie findings to the evidence and provide adequate reasons constituted a violation of procedural fairness.

The requests for reconsideration were granted, and the issues were remitted to be reheard before a different panel.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied several benefits, arguing the applicant's injuries fell within the Minor Injury Guideline and were subject to the $3,500 coverage limit.

The Tribunal found that the applicant's physical injuries were sprains and strains, which are defined as minor injuries.

The Tribunal preferred the psychological evidence indicating the applicant's psychological symptoms were subclinical and did not impair her function, supported by contemporaneous counselling records showing she maintained a normal, active lifestyle.

The Tribunal also rejected the argument that chronic pain removed the applicant from the minor injury limit, as there was no evidence of functional impairment.

Consequently, the claims for attendant care, treatment plans, and a non-earner benefit were dismissed.

The respondent insurer requested a reconsideration of a preliminary issue decision that allowed the applicant to proceed with a claim for income replacement benefits for the period prior to July 11, 2017.

The insurer argued the Tribunal violated procedural fairness and erred in law by splitting the limitation period analysis into pre- and post-denial periods.

The Vice-Chair dismissed the reconsideration request, finding no denial of natural justice and concluding that the insurer's termination letter was ambiguous regarding the pre-termination period, meaning the limitation period was not triggered until a subsequent accounting report was provided.

The applicant sought entitlement to an income replacement benefit (IRB) and various treatment plans following a 2011 motor vehicle accident.

The respondent insurer brought a preliminary issue motion arguing the IRB claim was statute-barred and the treatment claims were barred due to the applicant's failure to attend insurer examinations (IEs).

The Tribunal found the IRB claim was brought well beyond the two-year limitation period and that the applicant did not meet the test for substantial inability within 104 weeks.

The Tribunal also found the applicant failed to attend properly scheduled s. 44 IEs by imposing unreasonable conditions and refusing to cooperate, barring his treatment claims under s. 55 of the Schedule.

The application was dismissed.