Trina Morissette

The applicant, a pedestrian, was struck by a vehicle insured by the respondent.

The respondent was notified of the accident by its insured the following day but failed to contact the applicant or provide him with an accident benefits package.

The applicant submitted his application for benefits nearly two years later.

The respondent denied the claim, arguing the applicant failed to provide notice within seven days as required by section 32(1) of the Schedule.

The Tribunal found that the respondent's receipt of information from its insured satisfied the notice requirement and triggered its positive obligation under section 32(2) to assist the applicant.

The Tribunal held the applicant had a reasonable explanation for the delay and was not barred from proceeding with his claim.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits from the respondent insurer.

The respondent denied certain treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and requested the applicant attend insurer's examinations (IEs) under section 44 of the Schedule.

The applicant failed to attend the scheduled IEs and did not provide a reasonable explanation for his non-attendance.

On a preliminary issue, the Tribunal found that the notices of examination were valid and that the applicant was statute-barred under section 55(1)2 from proceeding with the issue of whether his injuries were predominantly minor and one treatment plan dependent on the MIG.

However, because the respondent failed to provide evidence linking three other treatment plans to the MIG, the applicant was permitted to proceed to a hearing on those remaining issues.

The applicant was struck by a vehicle while assisting another motorist and notified his insurer six days later, reporting he was sore and had been taken to the hospital.

The insurer closed the file after resolving the property damage claim without providing an accident benefits application package.

Over a year later, the applicant submitted an application for benefits (OCF-1).

The insurer raised a preliminary issue that the claim was time-barred.

The Tribunal found that the applicant's initial report triggered the insurer's positive obligation under section 32(2) of the Schedule to provide the application forms.

Because the insurer failed to do so, the 30-day deadline to submit the OCF-1 was never triggered.

The Tribunal held the applicant had a reasonable explanation for the delay and was not barred from proceeding with his claim.

The applicant sought statutory accident benefits following a motor vehicle accident but failed to submit her application (OCF-1) within the 30-day timeline prescribed by section 32(5) of the Schedule.

The applicant argued she did not consent to receiving the application package via her Gmail address and that her medical condition caused the delay.

The Tribunal admitted an audio recording of a telephone call confirming the applicant explicitly consented to email delivery to her Gmail account and was informed of the 30-day timeline.

Applying the Horvath principles, the Tribunal found the applicant's explanation was not credible or worthy of belief, and she failed to provide medical evidence supporting her inability to comply.

The application was dismissed as statute-barred under section 55(1)1.

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

The respondent insurer raised a preliminary issue that the applicant was statute-barred from proceeding to a hearing because she failed to attend scheduled insurer's examinations.

The applicant argued the notices of examination were non-compliant and the insurer failed to prove it arranged the examinations at its expense.

The Tribunal found the notices were compliant with section 44 of the Schedule and the applicant failed to provide a reasonable explanation for her non-attendance.

The application was dismissed as statute-barred under section 55(1)2, and the applicant's request for costs was denied.

The applicant sought post-104 week income replacement benefits (IRBs) after a motor vehicle accident.

The insurer argued the application was time-barred, relying on a denial issued before the 104-week mark when the applicant had temporarily returned to work.

The Tribunal found that the initial denial was premature regarding post-104 week IRBs, as entitlement to those benefits was not yet discoverable.

The Tribunal held the application was filed within the two-year limitation period triggered by a subsequent valid denial.

In the alternative, the Tribunal granted an extension of the limitation period under section 7 of the Licence Appeal Tribunal Act, finding minimal prejudice to the insurer and sufficient merit to the claim.

The applicant sought statutory accident benefits after being attacked by a dog that leaped from a parked vehicle.

The insurer denied the claim on the basis that the incident was not an 'accident' under the Schedule and that the applicant failed to provide timely notice.

The Tribunal found that the incident did not meet the purpose or causation tests for an accident, as the dog attack was an intervening act and the dominant feature of the injuries.

Furthermore, the applicant failed to provide a reasonable explanation for her seven-month delay in notifying the insurer.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident but failed to notify the respondent within seven days or submit his application (OCF-1) within 30 days.

The applicant argued the delay was due to a good faith error by his counsel, who initially submitted the claim to a different insurer.

The Tribunal found the explanation was not credible, noting the applicant continued to submit claims to both insurers even after the alleged error was discovered.

The Tribunal concluded the applicant failed to provide a reasonable explanation for the delays and was therefore barred under section 55(1) of the Schedule from proceeding with his application.

The applicant sought statutory accident benefits following an incident where she injured her knee after exiting her parked vehicle and stepping onto a curb.

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

The Licence Appeal Tribunal applied the two-part test from Caughy and found that the vehicle was merely being used for support, which is not an ordinary and well-known activity for which automobiles are put.

Furthermore, the Tribunal found that lifting her foot to step onto the curb was an intervening act and the dominant feature that caused her injuries, not the use or operation of the vehicle.

The application was dismissed.

The applicant sought statutory accident benefits after slipping and falling on ice while clearing snow from her vehicle.

The respondent insurer denied benefits, arguing the incident did not meet the definition of an 'accident' under the Schedule and questioning the applicant's credibility regarding the sequence of events.

The Tribunal accepted the applicant's version of events and applied the two-part purpose and causation test.

The Tribunal found that clearing snow is an ordinary use of a vehicle and that the ice was a normal risk, not an intervening cause.

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

The applicant sought statutory accident benefits after falling near her vehicle while preparing to transport her father.

The respondent denied benefits and raised preliminary issues regarding whether the incident was an "accident" and whether the application was statute-barred due to late notification.

The Tribunal found that the incident met the purpose and causation tests for an "accident" under the Schedule.

However, the applicant failed to notify the respondent within the prescribed time limits and did not provide a reasonable explanation for the four-year delay.

The Tribunal denied the applicant's request for relief from forfeiture, finding willful blindness and ongoing negligence.

The application was dismissed as statute-barred.

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

He notified the insurer of his intention to apply four months after the accident and submitted his application (OCF-1) fourteen months after the accident.

The insurer denied the claim due to non-compliance with the time limits in section 32 of the Statutory Accident Benefits Schedule.

The Licence Appeal Tribunal found that the applicant failed to provide a reasonable explanation for the delays, noting a lack of medical evidence to support his claims of cognitive impairment and finding his assertions regarding the insurer's lack of guidance not credible.

The application was statute-barred under section 55(1)1 of the Schedule.

The applicant was a passenger in a motor vehicle accident and did not apply for statutory accident benefits until nine months later.

The insurer argued the claim was barred under s. 32(1) of the Schedule for failing to provide notice within seven days.

Applying the recent Divisional Court decision in Hussein v. Intact, the Tribunal found that the driver's report of the accident on the day it occurred triggered the insurer's positive obligation to inquire about injuries and assist the applicant.

Because the insurer failed to fulfill this obligation, and the applicant provided a credible explanation for the delay, the Tribunal held the applicant was not barred from proceeding with her claim.

The applicant sought reconsideration of a Tribunal decision finding she was not catastrophically impaired.

She argued the Tribunal breached procedural fairness by allowing the respondent to cross-examine its own expert neurologist and by rejecting the expert's 5% whole person impairment rating for headaches without notice.

She also argued the Tribunal misapprehended evidence regarding her incontinence.

The Vice-Chair dismissed the request, finding the applicant had notice of the respondent's challenges to the expert's report, the Tribunal was entitled to reject ratings not supported by the AMA Guides, and the evidence supported the finding that there was no post-accident exacerbation of incontinence.

The applicant sought post-104-week income replacement benefits (IRBs) following a prior Tribunal decision that awarded her pre-104-week IRBs.

The respondent raised preliminary issues, arguing the claim was barred by res judicata and the two-year limitation period.

The Tribunal found res judicata did not apply because the legal test and entitlement for post-104-week IRBs had not been previously decided.

Applying the Supreme Court's decision in Yatar, the Tribunal held that the prior decision reinstated the applicant's IRBs, meaning the limitation period only restarted upon the respondent's subsequent denial in March 2025.

The preliminary objections were dismissed, costs were denied, and the matter was ordered to proceed to a hearing.

The applicant sought retroactive housekeeping benefits following a motor vehicle accident.

The respondent argued the application was barred by res judicata and the two-year limitation period, as a previous Tribunal decision denying these benefits had been quashed by the Divisional Court on consent, but the consent order only explicitly remitted the issue of attendant care benefits.

The Tribunal found that because the prior decision was quashed in its entirety, there was no final decision on housekeeping benefits, meaning res judicata did not apply.

The Tribunal also found the limitation period was met because the original claim was filed within two years of the denial and preserved despite the quashing.

The preliminary issues were dismissed, and the matter was allowed to proceed to a hearing, with the issue of costs added.

The applicant sought statutory accident benefits for a wood splitter conveyor.

The respondent argued the application was barred by res judicata, as the Tribunal had previously denied a treatment plan that included a wood splitter conveyor in a prior decision between the same parties.

The Tribunal found that the three preconditions for issue estoppel were met and declined to exercise its discretion to waive res judicata, finding no fresh evidence or unfairness.

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

The applicant sought catastrophic impairment benefits for psychological injuries sustained after her spouse was involved in a motor vehicle accident.

The respondent insurer initially denied the claim on the basis that the applicant was not directly involved in the accident, and later scheduled insurer's examinations (IEs) which the applicant refused to attend.

The respondent raised a preliminary issue seeking to bar the applicant from proceeding with her application due to her non-attendance.

The Tribunal found that the applicant had a reasonable explanation for not attending the IEs, as the respondent had predetermined she was legally ineligible for a catastrophic impairment designation.

The Tribunal permitted the applicant to proceed with her application subject to terms, including that the respondent reschedule the IEs and the parties consider adjourning the upcoming hearing.

The applicant sought statutory accident benefits, claiming a catastrophic impairment under Criterion 4 due to a traumatic brain injury sustained in a 2018 motor vehicle accident.

The respondent argued the application was barred by res judicata, as a prior 2023 Licence Appeal Tribunal decision had already determined the applicant did not sustain a neurological injury.

The Tribunal agreed, finding that the same question had been decided, the prior decision was final, and the parties were the same.

The Tribunal declined to exercise its discretion to waive res judicata, noting the applicant had the opportunity to present evidence of a brain injury at the first hearing but failed to do so.

The application was dismissed, with no costs awarded to either party.

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

The respondent insurer raised a preliminary issue, arguing the applicant was barred from proceeding because he failed to notify the insurer of his intention to apply within seven days, pursuant to section 32(1) of the Schedule.

The Tribunal found that the applicant's daughter had reported the accident on the same day, and the insurer failed to obtain clear confirmation that no injuries were sustained.

Applying recent jurisprudence, the Tribunal held the insurer had a positive obligation to provide the application forms under section 32(2).

Because the forms were never provided, the 30-day timeline to submit the application was never triggered.

The applicant was permitted to proceed with his claim.