Tavlin Kaur

The applicant requested a reconsideration of a preliminary issue decision which found she was not involved in an accident under the Statutory Accident Benefits Schedule.

The applicant argued the Tribunal made errors of fact regarding the cause of her injuries and errors of law in applying the test for an accident.

The adjudicator dismissed the request, finding that the applicant was attempting to re-argue her case and failed to meet the high threshold for reconsideration under Rule 18.2.

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

The insurer denied benefits and requested the applicant attend insurer's examinations (IEs) to assess her ongoing entitlement to income replacement benefits.

The applicant failed to attend the IEs, arguing they were not reasonably necessary as her primary injuries were neurological, not physical.

The Tribunal found the IEs were reasonably necessary given the applicant's physical injuries and the physical nature of her pre-accident employment.

As the applicant failed to provide a reasonable explanation for her non-attendance, she was barred from proceeding with her application before the Tribunal.

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

The respondent argued the matter had been settled for $250,000, which was paid to the applicant's former, now-deceased lawyer.

The applicant claimed she never signed the settlement documents or received the funds, alleging forgery.

The Tribunal dismissed the application for lack of jurisdiction, finding that under section 9.1(8) of Regulation 664, an applicant cannot apply to the Tribunal regarding benefits subject to a purported settlement without first returning the money received as consideration.

The Tribunal noted it lacks equitable jurisdiction to waive this mandatory statutory requirement.

The applicant sought statutory accident benefits following an incident.

The respondent denied benefits, arguing the incident was not an 'accident' under the Schedule.

A written hearing was scheduled to determine this preliminary issue.

The applicant failed to file any written submissions or evidence and did not request an extension.

The Tribunal proceeded with the written hearing in the applicant's absence and dismissed the application, finding the applicant failed to meet his evidentiary burden to establish he was involved in an accident.

The applicant sought statutory accident benefits following an alleged incident.

The respondent denied benefits, and the applicant applied to the Licence Appeal Tribunal.

A written hearing was scheduled to determine the preliminary issue of whether the applicant was involved in an 'accident'.

The applicant failed to file any written submissions or evidence.

The Tribunal proceeded with the written hearing under s. 7(2) of the Statutory Powers Procedure Act and dismissed the application, finding the applicant failed to meet her evidentiary burden.

The applicant sought statutory accident benefits after spilling hot coffee on his lap while in his vehicle at a drive-thru.

The respondent denied the claim, arguing the incident did not meet the definition of an 'accident' under section 3(1) of the Schedule and that the application was submitted late.

The Tribunal found that while the purpose test was met, the causation test failed because the improperly secured coffee cup lid was an intervening act that directly caused the injuries, breaking the chain of causation from the use of the vehicle.

Furthermore, the Tribunal held that the applicant was barred from proceeding because he failed to notify the respondent within the prescribed timelines and did not provide a reasonable explanation for the delay.

The application was dismissed.

The applicant, a pedestrian struck by an unknown driver, applied for statutory accident benefits approximately 18 months after the accident.

The respondent insurer argued the applicant was barred from proceeding due to failing to notify them within 7 days as required by section 32(1) of the Schedule.

The Tribunal found that the applicant, an unsophisticated party with limited education, provided a reasonable explanation for the delay, as he was unaware he could claim benefits from his own insurer for a pedestrian accident.

Balancing the prejudice to the insurer against the hardship to the applicant, the Tribunal granted relief from the time limit and allowed the application to proceed.

The respondent sought statutory accident benefits after slipping and falling on ice while exiting a vehicle.

The insurer denied benefits and brought a preliminary issue motion to determine if the incident met the definition of an 'accident' under s. 3(1) of the Schedule.

The Tribunal applied the purpose and causation tests, finding that while exiting a vehicle met the purpose test, the presence of ice was an intervening act that broke the chain of causation.

The Tribunal concluded the incident was not an accident and dismissed the application.

The applicant sought statutory accident benefits following a reported hit-and-run rear-end collision.

The respondent insurer denied benefits and sought repayment of $13,947.45, alleging the applicant staged the collision or wilfully misrepresented the facts, relying on an engineering report suggesting the vehicle reversed into a pole.

The Tribunal preferred the applicant's engineering experts, who found her account plausible based on real-world collision data.

The Tribunal also drew an adverse inference against the respondent for selling the vehicle before it could be inspected.

The Tribunal concluded the applicant was involved in an accident, did not wilfully misrepresent material facts, and the respondent was not entitled to repayment.

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

The respondent denied the benefits and raised a preliminary issue that the applicant was barred from proceeding because she failed to submit her application within the prescribed timelines.

The Tribunal found that while the initial disability certificate was complete, the application was submitted more than 30 days after receiving the application package.

As the applicant provided no submissions explaining the delay, she failed to establish a reasonable explanation and was barred from proceeding with her application.

The applicant sought statutory accident benefits after slipping on black ice while opening the rear door of her parked vehicle to load items.

The respondent denied benefits, arguing the incident did not meet the definition of an 'accident' under s. 3(1) of the Schedule.

The Tribunal applied the purpose and causation tests, finding that while the purpose test was met, the causation test failed.

The ice was an intervening cause and the dominant feature of the injuries, not the use or operation of the automobile.

The application was dismissed.

The applicant sought statutory accident benefits after her vehicle caught fire in her garage due to an electrical malfunction while she was asleep inside her home.

The insurer denied the claim on the basis that the incident was not an 'accident' under s. 3(1) of the Statutory Accident Benefits Schedule.

The Licence Appeal Tribunal held a preliminary issue hearing and found that the incident did not meet the purpose or causation tests.

The vehicle was not being used or operated at the time, and the fire was an intervening act that broke the chain of causation.

The application was dismissed.

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

At a case conference, the respondent requested a preliminary issue hearing regarding the applicant's alleged failure to comply with a section 33 request for information related to the income replacement benefit.

The Tribunal subsequently asked the parties if they would agree to have the section 33 issue heard at the substantive hearing instead.

The applicant agreed, but the respondent objected, arguing that a preliminary hearing would be more efficient.

The Tribunal found that section 33 non-compliance is a defence rather than a preliminary issue under section 55(1) of the Schedule.

To ensure efficiency and avoid the possibility of two separate hearings, the Tribunal ordered that the section 33 issue be heard alongside the substantive issues at the main hearing.

The applicant sought statutory accident benefits after spilling hot tea on herself while entering her parked vehicle.

The respondent denied benefits, arguing the incident was not an 'accident' under s. 3(1) of the Statutory Accident Benefits Schedule.

The Tribunal applied the purpose and causation tests, finding that while the purpose test was met, the causation test failed.

The Tribunal concluded that the improperly secured lid by the restaurant employee was an intervening act and the direct cause of the injuries, not the use or operation of the vehicle.

The application was dismissed.

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

The respondent raised preliminary issues arguing the applicant was barred from proceeding with claims for medical benefits, non-earner benefits, and attendant care benefits due to non-compliance with the Schedule.

The Tribunal found the applicant was not barred from proceeding with medical benefits because the respondent's notices of examination were deficient and failed to provide specific medical reasons.

However, the applicant was barred from proceeding with non-earner benefits because she failed to submit her application within the prescribed 30-day time limit and provided no reasonable explanation for the delay.

The applicant was also barred from proceeding with attendant care benefits because the Form 1 was not submitted electronically through the HCAI system as required by the applicable guideline.

The applicant sought statutory accident benefits after falling while exiting her parked vehicle.

She required assistance due to polio and fell when her right leg collapsed while shuffling away from the van with her husband.

The respondent denied benefits on the basis that the incident was not an 'accident' under s. 3(1) of the Schedule.

The Licence Appeal Tribunal applied the purpose and causation tests, finding that while parking is an ordinary use of a vehicle, the use or operation of the automobile did not directly cause the injuries.

The intervening cause was the applicant's leg collapsing, which was the dominant feature of the incident.

The application was dismissed.

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

The insurer denied benefits and scheduled insurer's examinations (IEs), including a psychological assessment.

The applicant failed to attend the psychological IE, arguing the notice of examination (NOE) lacked medical reasons.

The insurer argued the applicant was barred from proceeding under s. 55 of the Schedule.

The Tribunal found the NOEs were deficient because they failed to provide medical reasons for the psychological IE, as required by s. 44(5) and the principles in Smith.

Consequently, the applicant was not barred from proceeding with her application.

The applicant sought statutory accident benefits for psychological injuries sustained after her husband was struck by a vehicle insured by the respondent.

The respondent denied the claim on the basis that the applicant was not an 'insured person' under section 3(1) of the Schedule.

The Tribunal found that the applicant was not a named insured, specified driver, or spouse of a named insured under the policy.

Furthermore, the Tribunal applied the purpose and causation tests, concluding that the applicant's injuries arose from caring for her husband rather than the direct use or operation of an automobile.

The application was dismissed.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident.

The respondent brought a motion to bar the application on the basis of res judicata, arguing the Tribunal had already determined in a prior proceeding that the accident did not cause the applicant's physical impairments.

The Tribunal found that the four preconditions for res judicata were met and no exceptions applied.

The application was dismissed, and the applicant's request for costs was denied.

The applicant requested a reconsideration of a preliminary issue decision which found that the Settlement Disclosure Notice (SDN) was not defective.

The applicant argued that the Tribunal made errors of law and fact regarding the onus of proof and the compliance of the SDN with Regulation 664.

The adjudicator dismissed the request, finding that the applicant was attempting to re-argue her case and failed to establish any error of law or fact that would meet the high threshold for reconsideration.