Tavlin Kaur

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

The insurer denied benefits and requested particulars and statutory declarations regarding attendant care invoices under sections 46.2 and 46.3 of the Schedule.

The applicant failed to provide the requested information or a reasonable explanation for the failure.

The Tribunal found the insurer's requests were reasonable and held that the applicant was barred from proceeding with the application under section 55(1) of the Schedule.

The application was dismissed.

The applicant requested a reconsideration of a preliminary issue decision which found she had not provided a reasonable excuse for the delay in reporting her intent to seek accident benefits.

The applicant argued the Tribunal made an error of law regarding the application of sections 32, 34, and 55 of the Schedule.

The Tribunal dismissed the request, finding that the applicant was attempting to re-litigate the issue and raise new arguments not presented at the initial hearing.

The Tribunal affirmed its original application of the Schedule.

The applicant requested a reconsideration of a preliminary issue decision that found her application for accident benefits statute-barred under s. 61 of the Schedule.

The applicant argued the Tribunal made errors of law and fact regarding her employment status at the time of the accident and her entitlement to WSIB benefits.

The Tribunal dismissed the request, finding that the applicant was attempting to re-argue her case and failed to establish any errors of law or fact under Rule 18.2.

The applicant sought 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 erred in its application of the purpose and causation test regarding a natural gas explosion following a vehicle collision, and sought to introduce new medical evidence.

The Tribunal dismissed the request, finding no error of law or fact, and held that the new evidence could have been obtained previously and would not have changed the outcome.

The applicant sought statutory accident benefits for psychological injuries sustained after a verbal altercation with a Canada Post worker while driving.

The respondent denied the claim on the basis that the incident did not meet the definition of an 'accident' under section 3(1) of the Statutory Accident Benefits Schedule.

The Tribunal found that while the purpose test was met, the causation test was not, as the verbal assault was an intervening act that severed the chain of causation.

The application was dismissed.

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

The respondent denied the income replacement benefit and raised a preliminary issue that the applicant failed to submit a Disability Certificate (OCF-3) within the prescribed time.

The Tribunal found that the applicant did not submit the OCF-3 and provided no reasonable explanation for the delay.

Consequently, under the Statutory Accident Benefits Schedule, the applicant was barred from proceeding to a hearing for the income replacement benefit.

The application was dismissed.

The applicant requested a reconsideration of a preliminary issue decision which found she was not involved in an accident.

The applicant argued the Tribunal violated procedural fairness, made errors of law, and failed to properly apply the legal test for an accident.

The Tribunal dismissed the request, finding the applicant was attempting to re-litigate her case and that no errors of law or procedural fairness violations occurred.

The Tribunal confirmed its previous finding that the applicant's impairments arose from the aftermath of the accident, not the use or operation of an automobile.

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

The respondent insurer denied benefits and argued the applicant was barred from proceeding before the Tribunal under section 55(1)2 of the Schedule for failing to attend insurer examinations.

The Tribunal found the notices for the non-earner benefit examinations were compliant and the applicant lacked a reasonable excuse for non-attendance, barring her claim for that benefit.

However, the notices for the physiotherapy and chiropractic treatment plans were found to be deficient, meaning the applicant was not barred from proceeding with those claims.

The applicant requested a reconsideration of a preliminary issue decision which found that he did not provide a reasonable explanation for the delay in reporting his intention to seek accident benefits.

The applicant argued that the Tribunal violated procedural fairness by rendering legally insufficient reasons in its application of the Horvath test.

The Adjudicator dismissed the request, finding that the original decision provided clear and cogent reasons and that the applicant was attempting to re-argue his case.

The request for reconsideration was dismissed.

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

The insurer denied several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline.

The insurer raised a preliminary issue that the application was statute-barred under s. 56 of the Schedule as it was filed beyond the two-year limitation period.

The Tribunal found that the insurer's initial denial notices used boilerplate language and failed to provide adequate medical reasons, rendering them invalid under the principles in Smith and T.F. The limitation period was only triggered when the insurer provided detailed reasons in a later notice.

As the application was filed within two years of the valid notice, the applicant was not statute-barred from proceeding.

The applicant sought statutory accident benefits following a 2007 motor vehicle accident.

The insurer denied ongoing attendant care and housekeeping benefits in September 2018.

The applicant applied to the Tribunal in March 2022, beyond the two-year limitation period (even accounting for the O. Reg. 73/20 suspension).

The Tribunal found the 2018 denial was clear and unequivocal, meaning the application was filed late.

However, applying the Manuel factors, the Tribunal exercised its discretion under section 7 of the LAT Act to extend the limitation period, noting the appeal had merit due to the applicant's catastrophic impairment and the insurer suffered no prejudice as it had continued to conduct assessments during the delay.

The applicant requested a reconsideration of a preliminary issue decision which found she was not involved in an accident.

The applicant argued the Tribunal made an error of law or fact by failing to properly apply the causation test and the dominant feature test.

The Tribunal dismissed the request, finding that the applicant was attempting to re-argue her case and introduce new arguments not raised at the initial hearing.

The Tribunal concluded no error of law or fact was made.

The applicant's daughter died in a motor vehicle accident.

The applicant applied for a non-earner benefit two years later.

The respondent argued the claim was statute-barred due to the delay.

The Tribunal found that the applicant provided a reasonable explanation for the delay because the respondent failed to provide her with the required information and forms about available benefits after being notified of the accident.

The applicant was permitted to proceed with her application.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits.

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

A preliminary issue hearing was held to determine whether the applicant was barred from proceeding because he failed to notify the insurer of his intention to apply for benefits within seven days of the accident, as required by section 32(1) of the Schedule.

The Tribunal found that the applicant notified the insurer over two years after the accident and failed to provide a reasonable explanation for the delay.

Consequently, the application was dismissed pursuant to section 55(1) of the Schedule.

The applicant sought income replacement benefits following a motor vehicle accident but failed to submit a Disability Certificate (OCF-3) within 30 days of receiving the application package, as required by the Statutory Accident Benefits Schedule.

The applicant argued that the limitation period should be extended due to the COVID-19 pandemic under O. Reg. 73/20.

The Tribunal found that the limitation period expired well before the pandemic began and that the applicant failed to provide a reasonable explanation for the delay.

The Tribunal also held that it lacks jurisdiction to grant relief from forfeiture under section 129 of the Insurance Act.

The application was dismissed as statute-barred.

The applicant sought statutory accident benefits for psychological injuries arising from his mother's death in a 2016 motor vehicle accident.

The respondent insurer denied the claim, arguing the applicant failed to notify it of his intention to apply within the timelines under section 32(1) of the Schedule.

The Tribunal found that the applicant had notified the respondent of the accident in a timely manner when seeking death and funeral benefits, triggering the respondent's obligation under section 32(2) to provide application forms and information.

Because the respondent failed to prove it met this obligation, and the applicant provided a credible explanation that he was unaware he could make a claim, the Tribunal held the applicant had a reasonable explanation for the delay under section 34.

The applicant was permitted to proceed with his claim.

The applicant sought statutory accident benefits after slipping and falling on ice in a parking lot while walking around her vehicle to enter the driver's side.

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

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

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

The application was dismissed.

The applicant requested a reconsideration of a preliminary issue decision which found that she was not involved in an accident.

The applicant argued that the Tribunal made an error of law or fact by failing to properly apply the causation test and the 'but for' test.

The Tribunal dismissed the request, finding that the applicant was attempting to re-argue her case and that no error of law or fact was made in the original decision's application of the causation test.

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

The respondent insurer raised a preliminary issue, arguing the applicant was statute-barred from proceeding before the Tribunal due to his failure to attend scheduled insurer examinations under section 44 of the Schedule.

The Tribunal found that while the notices of examination were compliant, the respondent failed to make reasonable efforts to reschedule the examination to a convenient time after the applicant's representative requested a change.

The Tribunal exercised its discretion under section 55 to allow the application to proceed, subject to the condition that the applicant attend a rescheduled general practitioner examination.

The applicant sought statutory accident benefits after her neighbour repeatedly slammed her car door on her during a verbal altercation over the volume of her car radio while she was cleaning the vehicle.

The respondent denied benefits on the basis that the incident was an assault, not an accident.

The Licence Appeal Tribunal found that while cleaning a vehicle is an ordinary use, the assault by the neighbour was an intervening act that severed the chain of causation.

The Tribunal concluded the incident did not meet the definition of an 'accident' under s. 3(1) of the Schedule and dismissed the application.