107 total
Reconsideration dismissed; no error of law or fact in finding slip and fall was not an accident.
The respondent requested a reconsideration of a preliminary issue decision which found she was not involved in an 'accident' when she slipped and fell on ice after exiting a vehicle.
She alleged errors of law and fact, including the Tribunal's failure to consider section 32 of the Schedule, its reliance on binding Divisional Court case law over non-binding Tribunal decisions, and a perceived conflict of interest based on an allegation that the adjudicator and her counsel attended the same law school.
The Tribunal dismissed the request, finding no errors of law or fact, and noting that the bias allegation was factually inaccurate and insufficient to overcome the presumption of impartiality.
Psychological trauma triggered by viewing a video of the accident scene is not an 'accident'.
The applicant sought statutory accident benefits following a motor vehicle accident.
She claimed psychological injuries triggered by viewing a video of the accident scene, which showed a house where she had previously experienced abuse.
The Tribunal found that viewing the video did not constitute an 'accident' under the Schedule, as it did not arise from the ordinary use or operation of an automobile.
Consequently, her psychological impairments were not accident-related.
The Tribunal also found her physical injuries were predominantly minor and subject to the Minor Injury Guideline.
Claims for income replacement benefits, psychological treatment plans, an award, and interest were dismissed.
The Court of Appeal varied a broad mortgage declaration to clarify that prepayment without an interest penalty depends on specific terms like the Due on Sale clause.
The appellant, Bon-Star Inc., appealed an order declaring its mortgage a closed mortgage with no prepayment privileges and requiring compensation for lost interest upon prepayment.
The Court of Appeal allowed the appeal in part, varying the declarations to clarify that prepayment privileges were absent in favour of the mortgagor and that compensation for lost interest was required for the specific transaction where the "Due on Sale" clause was not invoked.
The court found the application judge erred in making a broad declaration regarding prepayment without compensation, as specific mortgage terms like the "Due on Sale" clause could alter prepayment conditions.
The court also upheld the application judge's discretionary decisions regarding adjournments and counsel appointment.
Application for accident benefits dismissed after applicant failed to file submissions on preliminary issue.
The applicant sought statutory accident benefits following an alleged motor vehicle accident.
The respondent denied benefits and raised a preliminary issue regarding whether the incident met the definition of an 'accident' under section 3(1) of the Schedule.
The applicant failed to file any submissions for the preliminary issue hearing.
The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to meet his evidentiary burden to establish that he was involved in an accident.
Application for withheld IRBs and special award dismissed as applicant failed to attend insurer's examinations without reasonable excuse.
The applicant was injured in a pedestrian knockdown accident and sought statutory accident benefits.
The respondent paid income replacement benefits (IRBs) initially but later terminated them after the applicant failed to attend multiple insurer's examinations (IEs).
The applicant eventually attended a psychiatric IE, after which the respondent reinstated IRBs and accepted she was catastrophically impaired, but refused to pay IRBs for the period of non-attendance.
The applicant sought payment of the withheld IRBs and a special award under s. 10 of Reg. 664, alleging the respondent unreasonably delayed payment, failed to accommodate her disabilities under the Human Rights Code, and improperly scheduled the IEs.
The Tribunal dismissed the application, finding the respondent provided proper notice, scheduled reasonably necessary IEs, and did not violate the Human Rights Code.
The Tribunal concluded the applicant failed to attend the IEs without a reasonable excuse, and the respondent did not unreasonably delay or withhold benefits.
Claims for deemed incurred treatment plans and a special award dismissed as insurer did not unreasonably delay catastrophic impairment determination.
The applicant sought payment for several treatment plans and a special award under Reg. 664, alleging the respondent unreasonably delayed determining her catastrophic impairment status and failed to accommodate her disabilities under the Human Rights Code during the insurer's examination (IE) process.
The Tribunal found that the respondent did not unreasonably delay the payment of benefits, noting that the delays in scheduling IEs were largely attributable to the applicant and her counsel's refusal to attend and objections to the assessment process.
The Tribunal also found no violation of the Human Rights Code, as the respondent attempted to accommodate the applicant by reducing the number of required IEs.
The claims were dismissed in their entirety.
Attendant care benefits partially granted for daytime needs; nighttime supervision and special award denied.
The applicant, who sustained a catastrophic impairment in a motor vehicle accident, sought attendant care benefits (ACB) of $4,339.71 per month and assistive devices.
The respondent insurer had reduced her ACB to $1,040.10 per month.
The Tribunal found that the applicant's claim was not statute-barred because the insurer failed to provide proper medical reasons for its refusal, meaning the limitation period had not commenced.
On the merits, the Tribunal accepted the applicant's need for daytime cueing and mobility assistance but rejected the need for nighttime supervisory care, awarding ACB at $1,630.72 per month.
The Tribunal declined to deem the expenses incurred, as the insurer had paid all submitted invoices and did not unreasonably delay payment.
Claims for assistive baby devices and a special award under Regulation 664 were dismissed.
Slip and fall on ice after exiting vehicle is not an accident under the Schedule.
The respondent sought statutory accident benefits after slipping and falling on ice while exiting a vehicle.
The insurer denied benefits and brought a preliminary issue motion to determine if the incident met the definition of an 'accident' under s. 3(1) of the Schedule.
The Tribunal applied the purpose and causation tests, finding that while exiting a vehicle met the purpose test, the presence of ice was an intervening act that broke the chain of causation.
The Tribunal concluded the incident was not an accident and dismissed the application.
Statutory accident benefits priority for 'involvement in an incident' does not require causation.
This appeal concerns the interpretation of "involved in the incident" under section 268(2) of the Insurance Act, which dictates liability for statutory accident benefits.
The Court of Appeal affirmed the Superior Court's decision that an arbitrator erred in law by introducing a causation requirement into the test for "involvement" in a priority dispute between an insured snowmobile's insurer (Gore Mutual) and the Motor Vehicle Accident Claims Fund.
The Court held that temporal, spatial, and participatory factors were sufficient to establish involvement, without requiring a direct causal link to the injuries.
Reconsideration granted in part; adjudicator erred in applying discoverability principle to toll limitation period for non-catastrophic benefits.
The respondent insurer requested a reconsideration of a Tribunal decision which found that the applicant was not statute-barred from disputing the denial of pre-104 attendant care benefits.
The adjudicator granted the reconsideration in part, finding she had erred in law by applying the principle of discoverability from Tomec to the first period of denied benefits, as the applicant's entitlement to those non-catastrophic benefits was not dependent on a catastrophic impairment designation.
The applicant was therefore statute-barred from claiming benefits for the first period, but the dispute regarding the second period was filed within the two-year limitation period.
Motion to bar proceeding for failure to attend insurer's examination denied; timetable for examination ordered.
The respondent insurer brought a motion under s. 55 of the Statutory Accident Benefits Schedule to bar the applicant's proceeding for attendant care benefits, alleging she failed to attend three insurer's examinations (IEs).
The Tribunal found that the applicant only failed to attend one properly scheduled IE, as the respondent had cancelled the other two.
Although the notice for the missed IE contained sufficient medical reasons, the Tribunal exercised its discretion under s. 55 to permit the application to proceed, noting the applicant had since been deemed catastrophically impaired and was willing to attend rescheduled IEs.
The Tribunal ordered a timetable for the applicant to attend an IE rather than barring or staying the application.
Limitation period for attendant care benefits did not apply due to discoverability; various treatment plans partially approved.
The applicant sought various statutory accident benefits following a motor vehicle accident, having previously been deemed to have sustained a catastrophic impairment.
The respondent argued the applicant was statute-barred from disputing the denial of attendant care benefits because he failed to do so within the two-year limitation period.
Applying the discoverability principles from Tomec, the Tribunal found the limitation period did not apply because the applicant could not have successfully disputed the denial until he had evidence of his catastrophic impairment.
The Tribunal partially granted the applicant's claims for treatment plans, including physiotherapy, psychological treatment, and catastrophic assessments, while denying mileage expenses for service providers.
The Tribunal also awarded attendant care benefits at reduced monthly amounts for specific periods, finding the applicant did not require 24/7 supervision.
Reconsideration of $1,000 costs order denied; Tribunal retained jurisdiction and provided procedural fairness.
The applicant requested a reconsideration of a Tribunal order requiring her to pay $1,000 in costs to the respondent after she withdrew her application.
She argued the Tribunal lacked jurisdiction because the file was closed and that it violated procedural fairness by not issuing a separate Notice of Hearing for the costs request.
The Tribunal denied the reconsideration, finding that the respondent made the costs request orally at the scheduled videoconference hearing before the file was closed, giving the Tribunal jurisdiction.
Furthermore, the applicant had adequate notice and an opportunity to provide written submissions on costs, satisfying procedural fairness requirements.
Preliminary decision cancelled after parties resolved issues regarding insurer's examinations prior to hearing.
The respondent raised a preliminary issue regarding the applicant's attendance at insurer's examinations, and the Tribunal released a preliminary decision.
However, the applicant subsequently informed the Tribunal that the preliminary issues had been resolved prior to the hearing.
The Tribunal ordered the cancellation of the preliminary decision and confirmed the applicant was not required to attend the examinations.
Applicant ordered to pay $1,000 in costs for unreasonable late withdrawal of application on hearing day.
The applicant withdrew her application for statutory accident benefits on the morning of the first day of a scheduled five-day hearing.
The respondent requested costs, arguing it had incurred significant preparation expenses and disbursements.
The Tribunal found that the applicant acted unreasonably and interfered with the Tribunal's process by waiting until the hearing began to withdraw without providing reasons.
The Tribunal ordered the applicant to pay the maximum allowable costs of $1,000 to the respondent.
Causation is not required for a vehicle to be 'involved in the incident' for benefits priority.
The appellant Minister appealed an arbitrator's decision holding the Motor Vehicle Accident Claims Fund liable to pay statutory accident benefits to a passenger injured in a snowmobile accident.
The passenger was riding on an uninsured snowmobile that crashed into a tree, followed 0.6 seconds later by an insured snowmobile crashing into the same tree.
The arbitrator found the insured snowmobile was not 'involved in the incident' because it did not cause or contribute to the injuries.
The Superior Court allowed the appeal, holding that the arbitrator erred in law by engrafting a causation requirement onto the plain meaning of 'involved in the incident' under s. 268(2)(1)(iii) of the Insurance Act.
Insurer's appeal of catastrophic impairment designation dismissed as no extricable error of law was demonstrated.
The appellant insurer appealed a Licence Appeal Tribunal reconsideration decision that upheld a finding that the respondent was catastrophically impaired and entitled to non-earner benefits following a motor vehicle accident.
The Divisional Court dismissed the appeal, finding that the appellant failed to identify any extricable error of law in the adjudicator's assessment of the medical evidence and whole person impairment ratings.
The Court also rejected the appellant's argument that the adjudicator lacked jurisdiction to hear the reconsideration request as a single member of the original two-member panel, noting that the Tribunal's rules permit such a procedure.
Rule 2.1.01 application to strike claims regarding accident benefits and surveillance dismissed as not the clearest of cases.
The defendant insurer brought a Rule 2.1.01 application to dismiss the plaintiffs' action as frivolous, vexatious, or an abuse of process.
The plaintiffs' claims arose from a motor vehicle accident, subsequent denial of statutory accident benefits, and alleged improper surveillance.
The plaintiffs also challenged the constitutional validity of certain Insurance Act provisions.
The court dismissed the application, finding that the constitutional challenge and the claims could not be properly assessed or struck out using the limited summary procedure under Rule 2.1.01, as it was not the clearest of cases.
Appeal allowed where motions judge refused to reconsider decision after administrative error caused submissions to be ignored.
The appellant appealed a decision dismissing its request to dismiss the action under Rule 2.1.01.
Due to an administrative error, the motions judge did not receive or consider the appellant's responding submissions before releasing her decision.
When notified of the error, the motions judge declined to reconsider the matter and directed the parties to pursue their remedies under the Rules.
The Divisional Court allowed the appeal, finding that the motions judge should have set aside her decision and either reconsidered it or directed it to another judge, rather than requiring an appeal.
The decision was set aside and remitted for a new hearing.
Motion for leave to appeal granted without costs.
The moving party, an insurance company, brought a motion for leave to appeal the unreported decisions of the motion judge dated January 4, 2021, and January 21, 2021.
The Divisional Court granted the motion for leave to appeal without costs.
The parties were directed to contact the court to schedule a case conference.