Rebecca Hines

The applicant was catastrophically injured when the ATV she was driving collided with a tree on private property.

The respondent denied statutory accident benefits, arguing the incident did not meet the definition of an 'accident' because the ATV was not required to be insured while on the owner's property.

The Licence Appeal Tribunal found that because the ATV was regularly driven along and across public municipal roadways to access different parts of the property, it was required to be insured under the Compulsory Automobile Insurance Act.

Consequently, the ATV met the enlarged statutory definition of an 'automobile', and the incident qualified as an 'accident' under the Schedule.

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

The respondent insurer denied three treatment plans for chiropractic services on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant sustained predominantly minor injuries, specifically a lumbar sprain and mechanical back pain, and failed to establish chronic pain or a psychological impairment that would warrant removal from the MIG.

The Tribunal also held that the respondent's denial notices complied with s. 38(8) of the Schedule by providing sufficient medical reasons based on insurer examinations.

The application was dismissed.

The appellants appealed a Notice of Proposal to Revoke Registration and an Immediate Temporary Suspension Order (ITSO) issued by the Registrar under the Motor Vehicle Dealers Act, 2002.

The parties agreed to extend the expiry date of the ITSO until the conclusion of the hearing on the Notice of Proposal.

The Tribunal granted the extension on consent and ordered a case conference to discuss further procedural elements.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing her injuries, including post-concussion syndrome, chronic pain, and psychological impairments, warranted removal from the Minor Injury Guideline (MIG).

The respondent denied the benefits, asserting the injuries were minor.

The Tribunal found the applicant's evidence, including expert reports, relied heavily on inconsistent self-reports and lacked objective medical support.

Preferring the respondent's insurer examination reports, the Tribunal concluded the applicant's injuries were predominantly minor and subject to the $3,500 MIG limit.

The claims for treatment plans outside the MIG and interest were dismissed.

The applicant, who was catastrophically impaired following a 2013 motor vehicle accident, sought non-earner benefits and payment for private school tuition.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove she suffered a complete inability to carry on a normal life within 104 weeks of the accident or continuously thereafter.

The Tribunal also denied the claim for private school tuition, as the applicant failed to establish it was reasonable and necessary, and the treatment plan was unsigned.

Claims for interest and a special award were consequently dismissed.

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

The respondent denied a physiotherapy treatment plan on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant sustained a concussion, removing her from the MIG.

However, the Tribunal dismissed the claim for the physiotherapy treatment plan, finding that the applicant failed to meet her onus to prove the treatment was reasonable and necessary.

Claims for an award and interest were also dismissed.

The applicant sought entitlement to statutory accident benefits for vision therapy, occupational therapy, a therapeutic mattress, and a psychological assessment following a 2019 motor vehicle accident.

The Licence Appeal Tribunal dismissed all claims, finding that the applicant failed to prove the treatments and assessments were reasonable and necessary.

The Tribunal preferred the respondent's insurer examination reports, which concluded that the proposed vision therapy lacked validated efficacy and that the applicant had the functional ability to perform pre-accident activities without the proposed occupational therapy.

Claims for interest and an award for unreasonable delay were also dismissed.

The applicant sought income replacement benefits, a physiotherapy treatment plan, interest, and an award following a motor vehicle accident.

The Tribunal found that the applicant failed to prove entitlement to the claimed quantum of $400 per week for income replacement benefits, noting the respondent had already paid past benefits and was paying an ongoing amount.

The claim for the physiotherapy treatment plan was dismissed as the respondent had already approved it.

The claims for interest and an award were also dismissed as no benefits were overdue and the applicant failed to address the award claim in submissions.

The applicant was involved in a motor vehicle accident and sought a determination that she sustained a catastrophic impairment under Criterion 8 of the Statutory Accident Benefits Schedule due to psychological impairments.

The Licence Appeal Tribunal found that the applicant failed to meet her burden of proof.

The Tribunal placed little weight on the applicant's expert assessors, noting their reliance on self-reports and lack of supporting medical documentation.

Conversely, the Tribunal accepted the respondent's psychiatric assessment, which concluded the applicant suffered only moderate impairments across the four spheres of functioning.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing his injuries fell outside the Minor Injury Guideline (MIG) due to chronic pain and psychological impairment.

The Licence Appeal Tribunal found the applicant's evidence insufficient to establish chronic pain or a psychological condition, preferring the respondent's medical examination which diagnosed soft-tissue injuries.

The Tribunal also found the respondent's denial notices complied with the Schedule.

The application was dismissed, and the applicant was denied the disputed treatment plans, interest, and an award.

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

The respondent denied the claims, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on chronic pain and a psychological impairment.

The Tribunal found that the medical evidence, including clinical notes and insurer examination reports, supported that the applicant sustained only minor soft tissue injuries.

The Tribunal concluded the applicant did not meet the onus of proving chronic pain with functional impairment or a psychological diagnosis.

As the MIG limit was exhausted, the claims for chiropractic and psychological services, as well as claims for interest and an award, were dismissed.

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

The Tribunal found the applicant sustained a catastrophic impairment under Criterion 7, reaching a 57% whole-person impairment rating.

The Tribunal also found the applicant met the test for post-104 income replacement benefits due to a complete inability to engage in suitable employment, but denied payment because the applicant failed to file income tax returns as required by section 4(5) of the Schedule.

Finally, the Tribunal determined the applicant was entitled to attendant care benefits of $889.21 per month, but denied payment because the expenses were not incurred.

The appellant appealed a Notice of Proposal to Refuse Application for a liquor sales licence.

The Tribunal found that the past conduct of the appellant's owners, which included repeated instances of overcapacity, serving alcohol in unlicensed areas, and failing to clear signs of service after hours, established reasonable grounds for belief that the business would not be carried on in accordance with the law and with integrity and honesty.

The Tribunal directed the Registrar to carry out the proposal to refuse the application.

The applicant sought a determination that he sustained a catastrophic impairment (CAT) following a 2020 motor vehicle accident, claiming entitlement to extended medical benefits.

The Tribunal assessed the applicant's physical and psychological impairments under Criteria 6, 7, and 8 of the Statutory Accident Benefits Schedule.

The Tribunal found insufficient evidence of radiculopathy and rejected several of the applicant's expert ratings, ultimately determining a 25% physical whole person impairment (WPI).

Combined with psychological impairments, the applicant did not meet the 55% WPI threshold.

The Tribunal also found the applicant did not suffer three marked impairments in his spheres of functioning.

As the applicant did not meet the CAT threshold and the non-CAT limits were exhausted, the application for medical benefits, an award, and interest was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing her injuries fell outside the Minor Injury Guideline (MIG) due to chronic pain and psychological impairment.

The Licence Appeal Tribunal found the applicant failed to meet her onus, noting the lack of supporting medical evidence and giving little weight to a chiropractor's disability certificate.

Relying on the insurer's medical examination, the Tribunal concluded the injuries were predominantly minor.

The claims for physiotherapy treatment plans outside the MIG, interest, and an award for unreasonable delay were dismissed.

The applicant sought accident benefits following a motor vehicle accident, claiming she sustained a catastrophic impairment due to psychological issues.

The Tribunal found that the applicant's extensive pre-existing psychological conditions were the primary cause of her impairments, and the accident was not a necessary cause.

The Tribunal preferred the respondent's medical evidence, noting the applicant's self-reports were inconsistent with her medical records, which showed improvement post-accident.

The application for catastrophic impairment, non-earner benefits, and other medical benefits was dismissed.

The applicant sought reconsideration of a decision finding she did not sustain a catastrophic impairment.

She argued the adjudicator breached procedural fairness and erred in law by giving little weight to late-filed evidence, including a CPP approval letter and an updated family doctor's letter, and by failing to address her primary submissions.

The Tribunal dismissed the request, finding no breach of procedural fairness in assigning little weight to evidence improperly submitted in reply or after the hearing concluded.

The Tribunal also found no error in its assessment of the medical evidence regarding the sphere of Adaptation.

The applicant sought a determination of catastrophic impairment and entitlement to income replacement benefits and medical benefits following a 2016 motor vehicle accident.

The Tribunal found that the accident was not a necessary cause of the applicant's right hip osteoarthritis aggravation or his psychological impairments, which were instead attributed to a post-accident stroke and subsequent loss of his driver's licence.

Consequently, the applicant did not meet the 55% whole person impairment threshold for catastrophic impairment.

The claims for income replacement benefits and medical assessments were also dismissed as the applicant failed to prove they were reasonable, necessary, or caused by the accident.

The applicant was a pedestrian struck by a vehicle and sought statutory accident benefits.

The respondent denied benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant sustained a concussion, removing him from the MIG.

However, the Tribunal dismissed the claims for attendant care benefits, occupational therapy, and a psychological assessment, finding them not reasonable and necessary given the applicant's return to work and independence in self-care.

The Tribunal approved treatment plans for physiotherapy and chiropractic services, noting they provided temporary pain relief and improved range of motion.

The claim for a special award was dismissed, but interest was awarded on the approved treatment plans.

The appellants appealed the denial of their two-year warranty and major structural defect (MSD) claims by Tarion Warranty Corporation regarding their newly constructed home.

The Tribunal found a breach of the two-year warranty due to water penetration in the garage caused by deficient lot grading and insufficient waterproofing, ordering the respondent to perform specific repairs.

However, the Tribunal dismissed the MSD claim, finding the appellants failed to prove that high humidity, a foundation crack, and sediment in the weeping tiles resulted in the failure of a structural load-bearing element or materially affected the use of the home.

A preliminary motion by the appellants to anonymize the decision was also denied.