Adrian Lomaga

The applicant sought various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The Tribunal first denied the applicant's request for a sealing order and anonymity, finding the applicant failed to meet the high threshold established in Sherman Estate.

On the merits, the Tribunal found the applicant was entitled to a gym membership, once-weekly personal training, a progress report, and a physiatry assessment, as these were reasonable and necessary to address his ongoing physical and psychological impairments.

The Tribunal denied the remaining claims for 90-minute psychological sessions and occupational therapy assessments.

The applicant's claim for a section 10 award for unreasonable withholding of benefits was also dismissed.

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

Prior to the hearing, the respondent conceded the applicant's catastrophic impairment designation and agreed to pay the disputed benefits.

The only remaining issue was the applicant's request for costs, arguing the respondent unreasonably delayed serving a psychiatric addendum report, causing unnecessary legal expense.

The Tribunal dismissed the costs request, finding the respondent acted diligently in following up with the assessment facility and served the report within the ten-day statutory timeline under s. 45(5) of the Schedule.

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, a pedestrian struck by a vehicle, sought a determination that her accident-related psychological impairments met the definition of catastrophic impairment under Criterion 8 of the Statutory Accident Benefits Schedule.

The Tribunal reviewed expert assessments from both parties and found that while the applicant had a marked impairment in activities of daily living, she only had moderate impairments in concentration, persistence and pace, and adaptation.

As the applicant did not demonstrate a marked impairment in three of the four spheres of functioning, she did not meet the catastrophic impairment threshold.

Consequently, her claims for various medical and rehabilitation benefits were dismissed because the non-catastrophic limits had been exhausted.

The plaintiffs, Maria Stiles, Jack Stiles, and The Estate of Peter Elie, brought a motion under rule 30.10 of the Rules of Civil Procedure for production of Toronto Police Service investigative records regarding the death of Peter Elie.

The court found the requested documents relevant and that it would be unfair to require the plaintiffs to proceed to trial without them.

The court ordered production of the records, subject to screening by the Attorney General for privilege or confidentiality, and awarded costs to the plaintiffs.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including a non-earner benefit, medical benefits, and assessment costs.

The insurer initially denied the claims on the basis of the Minor Injury Guideline but later conceded the injuries were non-minor.

The Tribunal found the applicant was not entitled to a non-earner benefit because she continued to engage in substantially all of her pre-accident activities, despite some limitations.

However, the Tribunal ordered the insurer to pay for occupational therapy, physiotherapy, and the costs of psychological, occupational therapy, and chronic pain assessments, finding them reasonable and necessary.

Claims for a special award and costs were dismissed.

The applicant sought reconsideration of a Licence Appeal Tribunal decision denying entitlement to two chiropractic treatment plans.

The applicant argued the Tribunal made significant errors of fact and sought to introduce new medical evidence.

The Vice-Chair dismissed the request, finding the proposed new evidence was either reasonably available prior to the hearing or would not have impacted the outcome.

The Vice-Chair further held that the Tribunal's weighing of the medical evidence, including assigning less weight to expert reports that lacked full medical history or relied on conjecture, was open to it on the evidence and did not constitute an error of fact.

In a medical malpractice action alleging lack of consent to a tubal ligation, the defendant physicians brought a motion under Rule 31.10 to examine the plaintiff's husband as a non-party.

The plaintiff opposed the motion, arguing that her husband had already provided written answers and that other parties present during the consent discussions had been examined.

The court dismissed the motion, finding that the plaintiff's inability to recall certain discussions did not amount to a constructive refusal, and the defendants failed to establish they were unable to obtain the information from other sources.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including post-104-week income replacement benefits (IRBs), attendant care benefits, and funding for medical assessments.

The Tribunal found the applicant was entitled to ongoing IRBs, as her post-concussion syndrome and chronic pain resulted in a complete inability to engage in any employment for which she was reasonably suited.

The Tribunal also approved a neuropsychological assessment but denied a speech language pathology assessment, noting the applicant's post-accident public speaking engagements.

Claims for attendant care benefits, a special award, and costs were dismissed.

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

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

The Tribunal found that the applicant failed to meet his onus of proving that the proposed chiropractic treatment plans were reasonable and necessary.

The applicant provided insufficient medical evidence to establish his accident-related physical injuries, particularly given a pre-existing back condition and a two-year gap in medical records following the accident.

The application was dismissed, and no interest or costs were awarded.

The applicant was injured in a motor vehicle accident and sought attendant care and housekeeping benefits.

The respondent insurer raised a limitation defence, arguing the applicant failed to challenge the denial of these benefits within the two-year limitation period under s. 56 of the Statutory Accident Benefits Schedule.

Applying the Court of Appeal's decision in Tomec, the adjudicator found that the limitation period for the housekeeping benefit and post-104-week attendant care benefit did not commence until the applicant was deemed catastrophically impaired, as she could not have discovered her entitlement before that designation.

However, the claim for attendant care services incurred prior to the 104-week mark was statute-barred, as it was clearly denied and not pursued within two years.

The applicant's request for costs was dismissed.

The applicant sought reconsideration of a Licence Appeal Tribunal decision confirming the quantum of her income replacement benefits.

The applicant argued that her fixed business expenses remained the same after the accident, despite her house cleaning business becoming inactive, and claimed an additional $2,758.01.

The Associate Chair denied the reconsideration request, finding no error in the Tribunal's conclusion that the applicant did not incur certain fixed business expenses while her business was inactive.

The applicant sought a non-earner benefit and the cost of an in-home assessment following a motor vehicle accident.

The adjudicator found the applicant was not a reliable witness and had failed to disclose significant post-accident activities, such as travelling, working, and doing housework, to her medical assessors.

Consequently, the adjudicator placed little weight on the applicant's medical reports and concluded she did not meet the stringent test for a non-earner benefit.

However, the adjudicator ordered the respondent to pay for the incurred in-home assessment and applicable interest.

The applicant's request for costs was denied.

The applicant, who was self-employed running a house cleaning business, sought increased Income Replacement Benefits (IRB) following a motor vehicle accident.

The dispute centered on the calculation of post-accident fixed business costs, specifically whether expenses like home office and management fees should be deducted when the applicant was not actively working.

The Tribunal agreed with the respondent insurer's calculation, finding that expenses not actually incurred post-accident should not be included.

The Tribunal also dismissed the applicant's claim for a special award, finding the insurer acted reasonably under section 33 of the Schedule in withholding benefits until the applicant provided requested bank statements to verify her post-accident income.

The applicant sought payment for several medical benefits and assessments following a motor vehicle accident, which the respondent insurer denied.

The Licence Appeal Tribunal found that the proposed physiotherapy and laser spinal decompression treatments were reasonable and necessary, rejecting the insurer's argument that they were merely passive therapies.

The Tribunal also approved a psycho-vocational and functional abilities evaluation, capping the cost at the statutory limit of $2,000 per assessment, and allowed an in-home assessment for attendant care needs despite the 104-week mark having passed, as the applicant might be entitled to future benefits if deemed catastrophically impaired.

The applicant sought statutory accident benefits following a motor vehicle accident, including costs for a physiatry assessment, an occupational therapy assessment, acupuncture, and pharmacotherapy.

The respondent denied the claims based on insurer's examinations concluding the applicant suffered only from minor physical injuries.

The Tribunal found the applicant's medical evidence, which diagnosed concussion, post-concussive disorder, and chronic pain, outweighed the respondent's evidence.

The Tribunal ordered the respondent to pay the disputed benefits and interest.

However, the Tribunal dismissed the applicant's claim for a special award, finding the respondent had reasonable grounds to doubt the claims based on its own specialist reports.

The applicant, who suffered from chronic pain following a motor vehicle accident, sought $62,877.65 from his insurer for the cost of constructing a residential therapy pool.

The insurer had previously approved and funded aqua therapy at a community pool.

The arbitrator found that while aqua therapy was beneficial for the applicant's re-conditioning, a custom residential pool was not a reasonable and necessary medical expense.

The evidence indicated that the applicant's treatment goals could be met through community pool sessions and other forms of exercise, and the high cost and convenience factors did not justify the expense.

The application for the medical benefit was dismissed.

The plaintiff in a serious motor vehicle personal injury action moved for leave to amend the statement of claim to increase the prayer for relief from $950,000 to $2 million after the action had been set down for trial.

The defendants argued the amendment would be highly prejudicial because it would expose the individual defendants personally beyond their $1 million liability coverage and require retention of excess counsel shortly before trial.

The court held that Rule 26.01 mandates leave absent prejudice that cannot be compensated by costs or an adjournment, and found the defendants had not met that onus because liability issues were unchanged and the amendment concerned only quantum.

Leave was granted, subject to a proportionality-based term requiring the plaintiff to indemnify the individual defendants for excess counsel costs on a substantial indemnity basis if damages above policy limits were not ultimately recovered.

Motion costs were awarded to the plaintiff.

The plaintiff moved for leave to amend his statement of claim to substitute the actual owner and property manager of premises where a trip and fall occurred, after the limitation period had expired.

The court held the case was one of misnomer, not the addition of new parties, because the pleading clearly identified the incident, location, date, and alleged liability of the owner, occupier, and manager at the relevant time.

Applying the Court of Appeal's misnomer jurisprudence, the court found a reasonable person reviewing the claim would have understood the intended defendants were the owner and manager in place on the accident date.

The court further held there was no basis to exercise residual discretion to refuse the correction because there was no actual prejudice, no significant delay, and prompt notice followed shortly after expiry of the limitation period.

On a summary judgment motion arising from a motor vehicle accident involving an uninsured son driving his father's vehicle, the moving defendant sought dismissal of the plaintiff's claim and an insurer's crossclaim on the basis that the vehicle had been taken without consent.

Applying the post-Hryniak summary judgment framework, the court held there was no genuine issue requiring a trial on consent to possession.

The court found that although the father had forbidden operation of the vehicle and the son had signed an excluded driver form, the son retained legal possession because the vehicle and keys remained available to him and had been entrusted for his use.

The owner was therefore potentially vicariously liable under s. 192 of the Highway Traffic Act, with negligence and damages left for trial.