Theresa McGee

The applicant requested reconsideration of a Licence Appeal Tribunal decision that dismissed his application for an income replacement benefit as time-barred.

The applicant argued the Tribunal erred in law by revisiting a prior interlocutory decision, failing to consider the respondent's post-termination conduct, and refusing to order payment of the benefit.

The Vice-Chair dismissed the reconsideration request, finding that the Tribunal properly applied binding appellate jurisprudence regarding the termination of benefits and the limitation period, and made no errors of law or procedural fairness.

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

The respondent raised a preliminary issue, arguing the applicant was barred from proceeding with his claims because he failed to attend insurer examinations under section 44 of the Schedule.

The Tribunal found the applicant failed to attend examinations for catastrophic impairment and income replacement benefits without a reasonable explanation, barring those claims under section 55.

However, the respondent did not establish that examinations were requested for the chronic pain assessment or attendant care benefits, allowing those claims to proceed.

The applicant sought statutory accident benefits following a motor vehicle accident, and the matter proceeded to a written preliminary issue hearing regarding catastrophic impairment.

The Tribunal identified that the applicant's representative was a licensed paralegal, who is prohibited by Law Society of Ontario By-Laws from acting in matters where catastrophic impairment is in dispute.

The Tribunal struck the paralegal's written submissions from the record and removed him as the representative of record, granting the applicant 30 days to retain authorized counsel or proceed self-represented.

The applicant sought statutory accident benefits after slipping and falling on an icy driveway while loading the trunk of his parked vehicle.

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

The Tribunal applied the two-part test from Chisholm and Greenhalgh, finding that loading a trunk is an ordinary use of an automobile and that this use directly caused the applicant's injuries.

The Tribunal concluded the incident was an accident and ordered the application to proceed to a hearing on the substantive issues.

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

The respondent raised a preliminary issue, arguing the applicant was barred from proceeding because she failed to attend multiple insurer's examinations under s. 44 of the Schedule.

The Tribunal found the applicant failed to attend seven properly requested examinations and failed to comply with a previous order to attend.

The application was dismissed under s. 55 of the Schedule.

The respondent's request for costs was denied, as the dismissal itself was the appropriate remedy for non-compliance.

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit and medical benefits for physiotherapy and chiropractic services.

The respondent denied the benefits on the basis that the applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident employment and that the proposed treatments were not reasonable and necessary.

The Tribunal dismissed the application, preferring the evidence of the respondent's assessors that the applicant's psychological and physical impairments did not meet the substantial inability test, and finding that the applicant had already received adequate treatment for her accident-related injuries.

The applicant sought attendant care and medical benefits following a motor vehicle accident.

The Tribunal dismissed the application, finding the applicant failed to prove he incurred the claimed attendant care expenses.

The applicant did not establish that his brother suffered an economic loss to provide care, nor did he provide sufficient details regarding professional care services.

The claims for medical benefits were also dismissed, as the insurer had already paid the incurred amounts for one treatment plan and no expenses had yet been incurred for the partially approved second plan.

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

The respondent raised preliminary issues, arguing the application was barred because the applicant failed to attend two scheduled insurer's examinations and incurred the cost of an in-home assessment before submitting a treatment plan.

The Tribunal found the applicant failed to attend the properly requested examinations without explanation, barring the application under section 55 of the Schedule.

The Tribunal also found the assessment expense was incurred before the treatment plan was submitted, relieving the respondent of liability under section 38.

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

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

At the outset of a scheduled videoconference hearing, the applicant brought a motion to confirm an automatic stay of proceedings under s. 25 of the Statutory Powers Procedure Act, arguing that her recent notice of appeal of an interlocutory decision triggered the stay.

Alternatively, she sought an adjournment because her counsel was unprepared to proceed.

The Tribunal dismissed the motion for a stay, finding that s. 25 does not apply to interlocutory appeals, which the Divisional Court has no jurisdiction to hear.

The Tribunal also denied the adjournment, noting that counsel had carriage of the file for seven months and failed to take necessary steps to prepare.

However, the Tribunal granted the applicant's subsequent request, on consent, to convert the matter to a written hearing.

The applicant requested reconsideration of two Licence Appeal Tribunal decisions regarding her entitlement to statutory accident benefits following a motor vehicle accident.

She argued that the Tribunal violated procedural fairness by refusing to combine her two applications and erred in its findings regarding her chronic pain and the Minor Injury Guideline.

The Vice-Chair dismissed the request, finding that the interlocutory order did not violate procedural fairness and that the hearing adjudicators made no errors of law or fact.

The Tribunal correctly applied the doctrine of res judicata to the Minor Injury Guideline determination and found that the new evidence did not conclusively impeach the original results.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied her claims for an income replacement benefit and medical benefits following a motor vehicle accident.

The applicant argued the Tribunal made errors of law and fact by failing to consider certain medical evidence, including hospital records and a psychological pre-screening report.

The Vice-Chair dismissed the request, finding that the Tribunal had properly considered and weighed the evidence in the original decision.

The Vice-Chair noted that dissatisfaction with the weighing of evidence is not a valid ground for reconsideration under Rule 18.2 of the Common Rules.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied his claims for a non-earner benefit, medical benefits, and an award for unreasonable delay.

The applicant argued the Tribunal made errors of fact and law and violated procedural fairness, including by misapplying the rule in Browne v. Dunn and improperly weighing medical evidence.

The Tribunal found that the request was filed within the 21-day time limit but dismissed the reconsideration on the merits.

The Tribunal concluded that it had properly weighed the evidence, correctly applied the burden of proof, and made no errors of law or procedural fairness in its original decision.

The applicants, three brothers involved in separate motor vehicle accidents, brought a motion seeking to disqualify the respondent insurer's counsel and adjuster, alleging breaches of privacy and a conflict of interest due to the sharing of information between their related accident benefits claims.

The Licence Appeal Tribunal held that while it has jurisdiction to disqualify counsel for a conflict of interest, it lacks the authority to disqualify an adjuster.

On the merits, the Tribunal found that the applicants had expressly consented to the sharing and pooling of their information for the purpose of investigating and verifying their claims when they signed the OCF-1 forms.

The Tribunal concluded there was no breach of privacy and no disqualifying conflict of interest, and dismissed the motion.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that limited her attendant care benefits.

She argued the Tribunal misinterpreted section 42(5) of the Statutory Accident Benefits Schedule as a bar against retroactive claims made before submitting a Form 1, and that it failed to consider her evidence and the impossibility of earlier compliance.

The Vice-Chair dismissed the request, finding no error of law or fact, and held that the Tribunal correctly applied the statutory limits and evidentiary requirements for attendant care claims.

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

A three-day videoconference hearing was scheduled.

The applicant's counsel removed himself from the record prior to the hearing, and the applicant failed to respond to the Tribunal's communications.

The applicant did not attend the hearing.

As the applicant bore the onus of proving entitlement and failed to present evidence, the application was dismissed.

The applicant sought reconsideration of a preliminary issue decision that barred her claims for accident benefits due to the expiry of the two-year limitation period.

The Tribunal had initially ruled it lacked discretion to extend the limitation period under s. 7 of the LAT Act.

Following the Divisional Court's decision in Fratarcangeli, which clarified that the Tribunal does have such discretion, the Tribunal reconsidered its decision.

Applying the Manuel test, the Tribunal found that the applicant failed to establish a bona fide intention to appeal within the limitation period, and that the delays—ranging from six months to nearly a decade—were substantial and prejudicial to the insurer.

The Tribunal concluded that the justice of the case did not require an extension of time and dismissed the reconsideration.

The applicant sought income replacement benefits after a 2016 motor vehicle accident.

The respondent insurer raised preliminary issues, arguing the applicant failed to apply within the 104-week timeframe and was statute-barred by the two-year limitation period.

The Tribunal found that the Schedule does not impose a strict timeline to apply for income replacement benefits, provided a completed disability certificate is submitted.

Furthermore, the limitation period was not triggered because the insurer's denial notices lacked medical reasons, failing to meet the requirements established in Varriano.

The application was permitted to proceed to a hearing on the merits.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and a medical benefit for physiotherapy.

The Licence Appeal Tribunal found that the applicant did not meet the disability test for a non-earner benefit, as he failed to establish a complete inability to carry on a normal life.

However, the respondent was ordered to pay the non-earner benefit for a limited period because it failed to provide timely notice of its denial under section 36 of the Schedule.

The Tribunal also found the proposed physiotherapy to be reasonable and necessary, ordering the respondent to fund the treatment plan.

The applicant's claim for an award under Regulation 664 was dismissed, as the respondent's conduct was not found to be unreasonable.

The applicant sought an income replacement benefit and medical benefits for physiotherapy and a psychological assessment following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove a substantial inability to perform the essential tasks of her employment.

The Tribunal also found the proposed medical benefits were not reasonable and necessary, noting a lack of objective medical evidence and contradictory expert reports.

The applicant sought medical and rehabilitation benefits following a motor vehicle accident.

The respondent denied a physiotherapy treatment plan and a chronic pain assessment.

The Tribunal found the physiotherapy treatment was reasonable and necessary, preferring the clinical records of the treating physician over the insurer's examiner.

However, the claim for the chronic pain assessment was dismissed because the applicant incurred the expense before submitting the treatment plan, contrary to section 38(2) of the Schedule.