5 total
Application for accident benefits statute-barred due to unexcused five-month delay in providing notice.
The applicant was involved in a motor vehicle accident and notified the respondent the following day, but explicitly denied sustaining any injuries.
Over five months later, the applicant submitted an application for accident benefits.
The respondent denied the claim on the basis that the applicant failed to provide notice of an intention to claim benefits within seven days, as required by section 32(1) of the Schedule.
The Tribunal found that the applicant did not comply with the notice requirement and failed to provide a reasonable explanation for the delay, rejecting arguments based on a language barrier and a belief that the injuries would resolve.
Consequently, the applicant was statute-barred from proceeding with the application.
Insurer's reconsideration request dismissed as it improperly sought to re-litigate the adjudicator's weighing of medical evidence.
The respondent insurer requested a reconsideration of a Licence Appeal Tribunal decision which found that the insured's injuries fell outside the Minor Injury Guideline (MIG) and awarded treatment plans, interest, and a 30% award under s. 10 of Regulation 664.
The insurer argued that the adjudicator erred in fact and law by preferring the evidence of the insured's medical assessor over its own, by finding the insured suffered from chronic pain, and by granting the award.
The Tribunal dismissed the request for reconsideration, holding that the adjudicator made no errors of fact or law but rather properly exercised their jurisdiction to weigh the conflicting medical evidence.
The Tribunal noted that a reconsideration is not an opportunity to re-litigate a party's position or challenge the weight assigned to evidence.
Non-earner benefit denied; applicant failed to prove complete inability to carry on a normal life.
The applicant, an 85-year-old with significant pre-existing medical conditions, sought a non-earner benefit following a motor vehicle accident.
The Licence Appeal Tribunal found that the applicant failed to meet the test of a complete inability to carry on a normal life, as the medical evidence indicated he remained independent with activities of daily living and his limitations were likely due to age-related degenerative changes.
The claims for a non-earner benefit, an award for unreasonable delay, and interest were dismissed.
Applicant removed from Minor Injury Guideline for psychological impairments; 30% award granted for unreasonable denial.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant suffered from accident-related psychological impairments and chronic pain, warranting removal from the MIG.
The Tribunal ordered the respondent to pay for a psychological assessment and psychological treatment, finding them reasonable and necessary.
Furthermore, the Tribunal awarded a 30% penalty under section 10 of Regulation 664, concluding that the respondent unreasonably withheld payment by ignoring documented psychological impairments and failing to reconsider its position when new medical evidence became available.
Application to enforce California Letter of Request for examination of Ontario accountant granted.
The applicants applied to enforce a Letter of Request issued by a California court to examine an Ontario accountant and obtain documents relating to a judgment debtor.
The applicants held a $41.6 million wrongful death judgment against the debtor and sought evidence for a related fraudulent conveyance action.
The court found that the statutory requirements under the Ontario and Canada Evidence Acts were met and exercised its discretion to enforce the request, noting the evidence was relevant, necessary, and not otherwise obtainable.