Caroline L. Meyer

The applicant requested a reconsideration of a decision denying an award for the respondent's alleged unreasonable withholding of income replacement benefits and costs.

The applicant argued the Tribunal erred in relying on the respondent's expert testimony and failing to consider the applicant's overall condition.

The Tribunal found no material error of law or fact that would have changed the outcome, noting that the respondent appropriately adjusted the claim and reasonably relied on its medical assessors.

The request for reconsideration was dismissed.

The respondent brought a motion to dismiss the application without a hearing, arguing the Tribunal lacked jurisdiction because the only issue in dispute was whether the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that the MIG classification could be decided as a standalone issue.

The Tribunal held that it does not have jurisdiction under s. 280(1) of the Insurance Act to determine MIG classification unless it is tied to a specific benefit dispute, as the MIG itself is not a statutory accident benefit but a framework establishing monetary limits.

The respondent's motion was granted and the application was dismissed.

The applicant was involved in a motor vehicle accident and sought income replacement benefits (IRB) and medical benefits beyond the Minor Injury Guideline (MIG) limit.

The respondent denied the benefits, arguing the injuries fell within the MIG.

The Tribunal found that the applicant's physical injuries were soft tissue in nature and fell within the MIG.

The applicant failed to provide sufficient medical evidence to prove a psychological injury that would warrant removal from the MIG.

Furthermore, the Tribunal found the applicant was not entitled to IRB because he continued to work post-accident and failed to establish a substantial inability to perform the essential tasks of his self-employment as a real estate agent.

The application was dismissed.

The applicant requested a reconsideration of a previous Tribunal decision which found that his accident-related injuries were predominantly minor.

The applicant argued that the Tribunal failed to consider medical evidence and was biased in relying on surveillance evidence, amounting to a violation of procedural fairness and a significant error of law or fact.

The Tribunal denied the request, finding that it had considered the medical evidence but found the surveillance evidence more persuasive, and that there was no error of law or fact that would have resulted in a different decision.

The applicant sought medical benefits for chiropractic services and hydrotherapy following a motor vehicle accident.

The insurer denied the treatment plans, arguing they were not reasonable and necessary.

The Tribunal found that surveillance evidence showing the applicant playing basketball and performing a 'slam dunk' contradicted his claims of limited functionality.

The Tribunal also noted that the treating chiropractor completed the treatment plans without having recently assessed the applicant.

The application was dismissed, and claims for interest and a special award were denied.

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

The insurer partially denied the cost of a slate of catastrophic examinations and fully denied claims for chiropractic treatment.

The Licence Appeal Tribunal found that the Functional Abilities Evaluation and associated travel and completion fees were reasonable and necessary for the catastrophic impairment determination.

However, the Tribunal dismissed the claims for the remaining catastrophic assessments, finding them duplicative, and denied the chiropractic treatment plans because the applicant failed to demonstrate they were reasonable and necessary.

The claim for an award for unreasonable delay was also dismissed.

Two Ontario residents injured in separate accidents outside Ontario involving an all-terrain vehicle (ATV) and a dirt bike sought statutory accident benefits (SABs) under their Ontario automobile insurance policies.

Both insurers denied coverage, arguing that the definition of "automobile" under Ontario law should be determined by the law of the jurisdiction where the accidents occurred (lex loci delicti).

The Court of Appeal held that Ontario law applies to the interpretation of Ontario contracts and statutes, and that the definition of "automobile" in the Insurance Act and Off-Road Vehicles Act applies uniformly regardless of where the accident occurs.

Both vehicles qualified as automobiles under the extended definition because they would have required insurance if operated in Ontario under the Off-Road Vehicles Act.

The court allowed the appeal of the insured and dismissed the appeal of the insurer.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision denying her claim for Non-Earner Benefits.

She argued that the adjudicator breached the rules of natural justice by refusing to allow her representative to make closing arguments after she testified through an interpreter.

The Tribunal agreed, finding that the case conference order did not expressly exclude closing submissions and that the applicant had not waived her right to make them.

Applying the Baker factors, the Tribunal concluded that the denial of closing arguments amounted to a breach of procedural fairness.

The request for reconsideration was allowed and a new hearing was ordered.

The applicant sought Non-Earner Benefits following a motor vehicle accident, claiming a complete inability to carry on a normal life due to physical and psychological impairments.

The Tribunal dismissed the application, finding that surveillance evidence showing the applicant shopping and lifting items contradicted her reported limitations.

The Tribunal also noted the applicant's pre-existing end-stage renal failure and an intervening accident as complicating factors.

Additionally, the Tribunal dismissed the applicant's procedural objections, finding no breach of her s. 14 Charter right to an interpreter and no denial of natural justice regarding the refusal to hear closing arguments.

The Applicant sought a determination that she sustained a catastrophic impairment following a motor vehicle accident, claiming her accident-related injuries necessitated cervical spinal fusion surgery.

The Respondent denied the claim, arguing the surgery resulted from pre-existing degenerative spinal conditions.

The Tribunal found that the Applicant's physical and psychological impairments combined to a 41% whole person impairment, falling short of the 55% threshold required for catastrophic impairment.

The Tribunal concluded that the Applicant's need for surgery was caused by the natural progression of her pre-existing congenital degenerative disc disease and spinal stenosis, and that an intervening chiropractic manipulation broke any chain of causation with the accident.

The claims for attendant care benefits and interest were consequently dismissed.

The applicant sought medical benefits for chiropractic and other services following a motor vehicle accident.

The insurer denied the treatment plans, arguing they were not reasonable and necessary.

The Licence Appeal Tribunal found that the applicant had not demonstrated significant improvement from previous similar treatments and that multiple assessors recommended a chronic pain program instead of continued passive, facility-based care.

The Tribunal concluded the treatment plans were not reasonable and necessary and dismissed the appeal.

The applicant, a taxi driver, was assaulted by passengers and subsequently fell into a ditch while attempting to close the van's door.

He applied for statutory accident benefits, but the insurer disputed whether the incident constituted an 'accident' under section 3(1) of the Statutory Accident Benefits Schedule.

The arbitrator applied the purpose and causation tests from Greenhalgh, finding that the taxi was being used for its ordinary purpose and that the entire series of events, starting with the use of the automobile, directly caused the impairment.

The arbitrator concluded that the applicant was involved in an accident.

The insurer brought a motion to stay an upcoming arbitration hearing regarding statutory accident benefits, arguing that the applicant had failed to produce necessary medical, educational, and employment records.

The applicant, who was injured as a child and now resides in the United States, claimed catastrophic impairment after a 14-year gap in treatment.

The arbitrator denied the stay at this time but ordered the production of the requested records from various third parties, including doctors and educational institutions.

The insurer was granted leave to renew the stay request if the documents are not produced 90 days before the hearing.

The appellant appealed an arbitrator's decision denying her claims for caregiver and non-earner benefits following a motor vehicle accident.

The Director's Delegate found no error of law in the arbitrator's weighing of the medical evidence, which preferred the insurer's assessments over the appellant's experts.

The Director's Delegate also rejected the argument that the arbitrator erred by allowing the appellant to proceed unrepresented, noting there was a presumption of capacity and no signs of mental difficulty that would require an inquiry under the Substitute Decisions Act.

The appeal was dismissed.

The insurer brought a motion for the production of various documents in an accident benefits dispute.

The arbitrator ordered the applicant to produce police, Crown, probation, and incarceration files related to his pre- and post-accident involvement in the criminal justice system, subject to claims of privilege, as they were relevant to his claims for non-earner benefits, attendant care, and catastrophic impairment.

The arbitrator denied the insurer's request for the applicant's complete elementary and middle school records and complete family doctor records, finding that the applicant had already produced the reasonably necessary documents.

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

After the insurer terminated benefits, the applicant sought arbitration but repeatedly failed to comply with production orders and did not attend pre-hearings.

The applicant's representatives withdrew due to an inability to obtain instructions.

When the applicant failed to appear at the scheduled hearing, the arbitrator proceeded in his absence.

The claims were dismissed as the applicant failed to meet the burden of proof, and the applicant was ordered to pay the insurer's arbitration expenses of $1,682.25.

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

The applicant failed to attend the pre-hearing discussion and the arbitration hearing, despite receiving proper notice.

The arbitrator proceeded in the applicant's absence pursuant to the Statutory Powers Procedure Act and the Dispute Resolution Practice Code.

As the applicant presented no evidence to meet his burden of proof, his claims for benefits and a special award were dismissed.

The applicant was ordered to pay the insurer's arbitration expenses in the amount of $1,035.61.

The deceased driver was killed in a single-car accident after losing control of his vehicle at a transition point between freshly paved asphalt and a foam surface treatment.

The trial judge apportioned liability 50% to the driver, 25% to the paving contractor, and 25% to the municipality.

On appeal, the Court of Appeal reversed the trial judge's decision, finding that the sole cause of the accident was the driver's reckless driving at excessive speeds, which absolved the appellants of liability under both statutory and common law duties of care.