Jonathan Batty

The respondent insurer requested a reconsideration of a Licence Appeal Tribunal decision that found the applicant was outside the Minor Injury Guideline (MIG).

The insurer argued the adjudicator misapplied the test for the pre-existing condition exception and improperly shifted the burden of proof.

The Associate Chair granted the reconsideration, finding that the adjudicator made a significant error by exempting the applicant from the MIG despite explicitly noting there was no compelling evidence, such as clinical notes and records, documenting a pre-existing condition that would prevent maximal recovery.

The original decision was set aside, and the applicant was found to be subject to the MIG.

The applicants requested a reconsideration of a motion decision that denied their request to exclude certain insurer's reports from evidence.

The applicants argued the adjudicator mischaracterized their position, asserting the reports should have been excluded because they were not served within the 10-day timeframe prescribed by s. 38(13) of the Statutory Accident Benefits Schedule.

The Associate Chair dismissed the reconsideration request, finding that even if the adjudicator misunderstood the specific date referenced, the alleged error was immaterial because the reports were directly relevant to the issues in dispute.

The applicant sought reconsideration of an interlocutory decision that denied an adjournment of a preliminary issue hearing.

The applicant had requested the adjournment pending the outcome of an application for leave to appeal to the Court of Appeal in a similar case regarding limitation periods.

The Tribunal dismissed the reconsideration request, finding no error of law or breach of procedural fairness in the original decision.

The Tribunal emphasized the need for fair, efficient, and timely conduct of proceedings, noting that delaying hearings to await potential outcomes in unrelated civil actions is impractical and unfair.

The respondent insurer filed a request for reconsideration of an adjudicator's interlocutory decision denying its request for the production of the applicant's pre-accident medical and income records.

The Associate Chair dismissed the request for reconsideration.

Under the amended Rule 18.1 of the Common Rules of Practice and Procedure, which applies to orders issued on or after February 7, 2019, requests for reconsideration are only accepted for decisions that finally dispose of an appeal.

Because the proceeding was ongoing and the motion decision did not finally dispose of the appeal, the request was dismissed.

The respondent insurer filed a request for reconsideration of an adjudicator's preliminary decision which found that an attendant care benefit claim was not statute-barred.

The Associate Chair dismissed the request, noting that under the amended Licence Appeal Tribunal Rules of Practice and Procedure, requests for reconsideration are only accepted for decisions that finally dispose of an appeal.

The respondent insurer filed a request for reconsideration of an adjudicator's decision granting the applicant's claim for income replacement benefits and psychological treatment.

The Associate Chair dismissed the request, finding that the respondent failed to meet the criteria for reconsideration under Rule 18.2.

The request was vague, provided no particulars of the alleged error of law, and lacked supporting analysis or evidence.

The respondent insurer requested a reconsideration of a preliminary decision which found that the applicant's claims for attendant care and medical benefits were not statute-barred.

The original adjudicator had concluded that the insurer's denial notices were not 'clear and unequivocal' because they included an application for catastrophic impairment, which might confuse an unsophisticated person.

On reconsideration, the Associate Chair found that the adjudicator made a significant error of law or fact.

The Associate Chair held that the denial notices, which included standard-form disclosures of the right to appeal and the two-year limitation period, were clear and unequivocal.

Consequently, the reconsideration was granted, and the applicant's claims for the disputed benefits were dismissed as statute-barred.

The applicant filed a request for reconsideration of a decision denying the cost of an assessment, interest, and an award.

The request was filed beyond the 21-day time limit set out in Rule 18.1 of the Common Rules of Practice and Procedure.

The applicant's representative claimed not to have received the original decision but provided no explanation.

Furthermore, the applicant failed to meet the criteria for reconsideration under Rule 18.2, as the request was vague and provided no supporting analysis for the assertion that the adjudicator erred in law and fact.

The request for reconsideration was dismissed.

The respondent insurer filed a request for reconsideration of a preliminary decision more than 12 months after the 21-day deadline, arguing that its timely appeal to the Divisional Court demonstrated its intention to pursue a review.

The Tribunal declined to extend the deadline under section 7 of the Licence Appeal Tribunal Act or Rule 3, finding that allowing the late reconsideration would not promote an efficient or timely resolution and would prejudice the applicant who had already responded to the unsuccessful court appeal.

The request for reconsideration was dismissed.

The respondent insurer requested reconsideration of an interlocutory order that combined two applications and adjourned hearing dates.

The Licence Appeal Tribunal dismissed the request, noting that under the amended Rule 18.1 of the Common Rules of Practice and Procedure, requests for reconsideration are only accepted for decisions that finally dispose of an appeal.

The respondent insurer requested a reconsideration of an interlocutory motion order requiring the production of adjuster's log notes, the complete accident benefits file, and IME raw data.

The Licence Appeal Tribunal dismissed the request, noting that under the amended Rule 18.1 of the Common Rules of Practice and Procedure, requests for reconsideration are only accepted for decisions that finally dispose of an appeal.

Because the proceeding was ongoing, the request was dismissed.

The applicant requested a reconsideration of a previous order denying an adjournment of a scheduled hearing.

The applicant's counsel provided compelling personal reasons for being unable to attend on short notice, and the respondent consented to the adjournment.

The Associate Chair granted the reconsideration and adjourned the hearing to mutually agreeable dates.

The applicant requested reconsideration of a preliminary decision that found their claims for income replacement and attendant care benefits were statute-barred.

The adjudicator noted a typographical error regarding the attendant care benefits and amended the preliminary decision under Rule 17 to allow that issue to proceed.

However, the request for reconsideration was dismissed because, under the amended Rule 18.1, reconsiderations are only accepted for decisions that finally dispose of an appeal, and this proceeding was ongoing.

The applicant requested reconsideration of a motion order that granted the respondent's request for an adjournment and partially granted the applicant's request for further productions.

The applicant argued the order was procedurally unfair, erred in law, gave rise to a reasonable apprehension of bias, and caused prejudice due to delay.

The Associate Chair dismissed the reconsideration request, finding no procedural unfairness, no error in granting the adjournment to allow the respondent to respond to new issues, no evidence of bias, and that the delay was largely attributable to the applicant's own actions.

The appellant requested a reconsideration of the Licence Appeal Tribunal's decision confirming the suspension of his driver's licence for medical reasons.

He sought to submit additional medical documentation, including an EEG test and reports from his chiropractor and family doctor.

The Associate Chair dismissed the request, finding that the proposed evidence could reasonably have been obtained before the original hearing and that the reconsideration process is not intended to allow parties to gather additional evidence after a decision is made.

The respondent insurance company filed a request for reconsideration of an adjudicator's interlocutory order denying its motion to dismiss the applicant's claim for housekeeping benefits.

The Associate Chair dismissed the request, noting that under the recently amended Rule 18.1 of the Tribunal's Common Rules of Practice and Procedure, requests for reconsideration are only accepted for decisions that finally dispose of an appeal.

Because the proceeding was ongoing, the request was dismissed.

The applicant requested reconsideration of a Case Conference Order that directed a preliminary issue hearing in writing and denied production of a contract between the insurer and a third-party assessment company.

The applicant argued the contract was unlawful because the assessment company was not a regulated health professional.

The Associate Chair denied the reconsideration, finding that section 44 of the SABS does not prohibit insurers from using third-party service providers to arrange assessments, provided the actual assessor is a regulated health professional.

The Associate Chair also upheld the decision to proceed with a written hearing.

The applicant requested a reconsideration of a Case Conference Order that precluded the use of affidavit evidence in a written hearing concerning attendant care benefits.

The Associate Chair converted the reconsideration request into a motion to vary the order.

Finding that precluding affidavit evidence would bar the applicant from proving her case regarding the type, duration, and necessity of services provided, and noting no prejudice to the respondent who retains the right of cross-examination, the Associate Chair granted the motion to permit affidavit evidence.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found his injuries from a motor vehicle accident were governed by the Minor Injury Guideline (MIG).

The applicant argued the Tribunal failed to give sufficient weight to his evidence regarding pre-existing psychological and physical conditions.

The Associate Chair denied the request, finding the Tribunal had properly assessed the evidence and the applicant failed to identify any significant error of fact or law.

The reconsideration request was dismissed.

The respondent requested a reconsideration of a motion decision that denied its request to adjourn a case conference.

The respondent argued that proceeding with the case conference was procedurally unfair because catastrophic impairment assessments had not yet been completed.

The Associate Chair denied the reconsideration, finding that case conferences are useful for clarifying procedural issues and do not require finalized defences.

The Tribunal noted that the reconsideration process should not be used as an indirect means of obtaining an adjournment.