Lori Marzinotto

The applicant was injured in a severe head-on motor vehicle collision while driving a commercial truck.

He sought various statutory accident benefits, including post-104 week income replacement benefits (IRBs), attendant care benefits, medical benefits, and the cost of several assessments.

The Licence Appeal Tribunal found that the applicant suffered a complete inability to engage in employment due to a combination of physical and psychological impairments, granting ongoing IRBs.

The Tribunal also approved funding for psychological treatment, a chronic pain assessment, a psychological assessment, and an occupational therapy driving assessment for catastrophic impairment determination.

However, claims for attendant care benefits, a mattress, a clinical file review fee, and a special award were dismissed.

The applicant sought an award under s. 10 of O. Reg. 664, alleging the respondent unreasonably withheld or delayed payment of a treatment plan (OCF-18) following a motor vehicle accident.

The treatment plan was initially denied based on an insurer's examination but was later approved at a case conference.

The Tribunal found that the respondent did not unreasonably withhold or delay payment, as it had relied on the medical evidence and the opinion of the insurer's examination assessor at the time of the denial.

The application for an award was dismissed.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision, including a non-earner benefit and various medical and rehabilitation benefits for chiropractic, physiotherapy, assistive devices, and an in-home assessment.

The Tribunal found that the applicant failed to prove on a balance of probabilities that she suffered a complete inability to carry on a normal life, noting her evidence was inconsistent and uncorroborated.

The Tribunal also dismissed the claims for medical and rehabilitation benefits, relying on insurer's examinations and finding that the proposed treatment plans were not reasonable and necessary given the lack of functional improvement from prior treatments.

The application was dismissed in its entirety.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the respondent terminated them based on insurer examinations.

The applicant sought reinstatement of the benefits and approval for a physiatry assessment.

The Tribunal found that the insurer's medical reports did not support termination and that the applicant continued to suffer a substantial inability to perform the essential tasks of his pre-accident employment as a realtor and motel manager.

The Tribunal awarded income replacement benefits up to the 104-week mark, approved the physiatry assessment, and awarded interest, but denied the applicant's request for costs and a special award.

The applicant, an international student, was injured in a motor vehicle accident and sought visitor's expenses for her mother's travel from China to Canada, claiming the visits were necessary for her recovery.

The respondent denied the benefits.

The Licence Appeal Tribunal found numerous inconsistencies in the applicant's evidence regarding her injuries, employment, and when she informed her family about the accident.

The Tribunal concluded that the applicant failed to prove on a balance of probabilities that the visitor's expenses were reasonable, necessary, or incurred as a result of the accident.

The application was dismissed.

The appellant appealed a Notice of Proposal by the Registrar to revoke her registration as a real estate broker due to professional misconduct, including accepting cash gifts and mobile phones from a client and making misrepresentations to the Real Estate Council of Ontario.

Prior to the hearing, the parties reached a settlement.

The Licence Appeal Tribunal issued a consent order directing the Registrar to suspend the appellant's registration for 28 weeks instead of revoking it, subject to conditions including a five-year prohibition on acting as a broker of record, restrictions on accepting gifts or entering lending arrangements with clients, and an order to pay $17,000 in restitution to the client.

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

The parties waived the requirement for a hearing and agreed to a Consent Order imposing conditions on the appellants' registration.

The conditions require compliance with the Act, disclosure of changes in officers or directors, and restrictions related to Garry Letichever.

Subject to these conditions, the registrations of Auto Quest Group and Yana Letichever will continue.

The applicant was injured in a motor vehicle accident and sought various statutory accident benefits, which the respondent insurer denied.

The Tribunal found that the applicant's injuries fell outside the Minor Injury Guideline (MIG) due to a pre-existing low back condition that impacted his recovery.

The Tribunal partially allowed the claim for physiotherapy services, finding two treatment plans reasonable and necessary based on medical evidence that the applicant had not yet reached maximum medical improvement.

However, the Tribunal dismissed the claims for further physiotherapy, functional and medical assessments, transportation costs, and the cost of an OCF-3, as the applicant failed to prove they were reasonable and necessary.

The respondent insurer requested a reconsideration of a Tribunal decision which found that assessments to determine catastrophic impairment are excluded from the $50,000 limit for medical and rehabilitation benefits under the Statutory Accident Benefits Schedule.

The respondent argued the Tribunal erred in law in its interpretation of section 18(5) and by concluding that catastrophic impairment assessments are not benefits.

The Tribunal dismissed the request, finding no error of law in its holistic interpretation of the legislation or its conclusion that such assessments are not a benefit or payment to an insured person.

The applicant was struck by a vehicle while riding his bicycle and applied for a determination of catastrophic impairment based on mental and behavioural disorders, specifically in the sphere of Adaptation.

The Tribunal weighed competing expert evidence, noting the applicant's upward trajectory in employment and poor validity testing results.

The Tribunal gave little weight to the applicant's occupational therapy assessment, finding the simulated work tasks unrealistic compared to his actual sustained employment.

Preferring the respondent's psychiatric evidence, the Tribunal found the applicant's impairments did not rise to the level of a marked impairment and dismissed the application.

The applicant in a statutory accident benefits dispute brought motions to state a case for contempt, add the respondent's counsel and adjuster as witnesses, seek third-party productions, and adjourn the hearing.

The applicant alleged that the respondent's counsel interfered with her attempts to obtain personal information from independent medical examiners under PIPEDA.

The Tribunal denied the motion to add witnesses, finding no evidence that counsel or the adjuster were necessary witnesses and noting that the applicant's communications with the examiners were inappropriate attempts to cross-examine them outside the hearing.

The production motion was denied as untimely.

The adjournment motion was granted, and a case conference was ordered to address the contempt motion.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.

He previously settled a 2017 application before the Licence Appeal Tribunal, signing a release and settlement disclosure notice that included attendant care benefits 'to date and ongoing'.

He subsequently filed a 2018 application seeking attendant care benefits.

The Tribunal held a preliminary issue hearing to determine if the 2018 claim was barred by the 2017 settlement.

The Tribunal found the settlement documents were unambiguous and clearly released the insurer from ongoing attendant care benefit claims.

The application was dismissed.

The applicant sought to add a denied treatment plan for a physiatry assessment as an issue in dispute to an existing application for statutory accident benefits.

The respondent opposed, arguing procedural unfairness because the applicant died before attending a scheduled insurer's examination.

The Tribunal allowed the issue to be added, finding no prejudice to the respondent and noting that bifurcating the issues would not be just, expeditious, or cost-effective.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.

Due to conflicting information regarding his employment status, the insurer requested an election of benefits.

The applicant elected to receive income replacement benefits (IRBs).

After the insurer denied the IRBs, the applicant attempted to re-elect to receive non-earner benefits (NEBs).

The Tribunal held that under section 35(3) of the Schedule, an election is final and can only be changed if the applicant is determined to have sustained a catastrophic impairment.

As there was no catastrophic impairment, the applicant was not entitled to re-elect NEBs.

The applicant sought income replacement benefits following a motor vehicle accident.

The respondent insurer brought a motion for repayment of benefits already paid, alleging wilful misrepresentation.

The Tribunal found that the applicant deliberately misrepresented his employment status, claiming to be an employee rather than self-employed, and submitted falsified pay slips to support his claim.

Surveillance evidence further undermined the applicant's credibility.

The Tribunal dismissed the application for ongoing benefits and ordered the applicant to repay $59,817.21 in benefits previously paid due to his wilful misrepresentation.

The respondent was also found entitled to an off-set for CPP disability benefits.

The applicant sought reconsideration of a Licence Appeal Tribunal decision that denied his claim for ongoing Income Replacement Benefits (IRBs) following a motor vehicle accident.

The applicant argued the adjudicator erred in law by admitting the respondent's medical reports without expert duty forms, by requiring proof of a scientific psychiatric illness, and by misapprehending evidence regarding his medication and marijuana use.

The Vice-Chair dismissed the reconsideration request, finding that the Executive Chair had the statutory authority to delegate the reconsideration, the adjudicator properly exercised discretion in admitting the reports, and there was no error of law or misapprehension of evidence in concluding the applicant failed to meet his burden of proof.

The applicant requested a reconsideration of a Tribunal decision that barred him from applying for income replacement benefits due to his failure to attend an insurer's examination.

The Vice-Chair found that the Tribunal made a significant error of law by concluding that the insurer's notice of the orthopaedic assessment complied with s. 44(5)(c) of the Schedule.

The notice failed to state the regulated health profession of the assessor.

As the notice was non-compliant, the insurer could not rely on s. 55(1)2 to bar the application.

The reconsideration was granted, and the withheld income replacement benefits were ordered payable, though a claim for a special award was denied.

Both the applicant and respondent sought reconsideration of a Tribunal decision regarding statutory accident benefits.

The Vice-Chair found the Tribunal erred in awarding attendant care benefits at the Form 1 amount of $2,894.99 per month for a period when the applicant's wife provided care, reducing it to her actual economic loss of $935.00 per month.

The Vice-Chair also found the Tribunal erred in its formula for calculating the special award under s. 10 of O. Reg. 664 and directed the parties to recalculate it.

The Tribunal did not err in fixing an end date for benefits at the 104-week mark or in finding the respondent unreasonably withheld benefits.

Following a successful hearing for statutory accident benefits, the applicant sought a special award and costs.

The Licence Appeal Tribunal found that the insurer unreasonably withheld and delayed payments by failing to properly respond to treatment plans, failing to explain why injuries were no longer in the Minor Injury Guideline, and failing to continually adjust the file despite conflicting insurer examination reports.

The Tribunal awarded the applicant a special award of $4,711.77 (representing 30% to 50% of the delayed benefits) plus interest.

Both parties' requests for costs were dismissed, as neither party's conduct rose to the level of being unreasonable, frivolous, vexatious, or in bad faith.

The applicant requested a reconsideration of a preliminary issue decision which found that an assault at an automobile repair shop did not constitute an 'accident' under the Statutory Accident Benefits Schedule.

The Tribunal dismissed the request because the applicant failed to specify the grounds for reconsideration under Rule 18.2.

Furthermore, on the merits, the Tribunal found no significant error of law or fact in the original decision, which correctly concluded that the assault was an intervening act breaking the chain of causation between the use of the automobile and the applicant's impairments.