Christopher Collins

The applicant sought statutory accident benefits for optometry services following a motor vehicle accident.

The respondent denied the treatment plan because the applicant failed to attend scheduled insurer's examinations (IEs) in Toronto and Brampton, citing the inconvenience of travelling from London.

The Tribunal found that the respondent made reasonable efforts to schedule the IEs at a convenient location, as there were no available specialists in the London area.

Because the applicant failed to attend the IEs without a reasonable excuse, she was barred from proceeding with her claim under s. 55 of the Statutory Accident Benefits Schedule.

The application was dismissed.

The respondent brought a motion to dismiss or stay the application because the applicant failed to attend four insurer's examinations (IEs) related to his claim for post-104 income replacement benefits.

The Tribunal denied the motion to dismiss, finding it would be unduly prejudicial to the applicant.

However, the Tribunal granted a 120-day stay to allow the respondent to conduct vocational, kinesiology, and orthopaedic assessments, which were found to be reasonably necessary under s. 44(1) of the Schedule.

The Tribunal found that a requested psychiatric assessment was not reasonably necessary as there was no reasonable nexus to the applicant's injuries.

The applicant was injured in a motorcycle accident and sought a medical benefit for physiotherapy services under the Statutory Accident Benefits Schedule.

The respondent insurer denied the treatment plan, arguing that the applicant had improved and could perform exercises independently.

The Tribunal found that the treatment plan's goals of pain reduction and improved function were reasonable and necessary given the applicant's injuries, which included post-concussion syndrome.

The Tribunal ordered the respondent to pay the $3,003.85 treatment plan and interest on any incurred expenses.

The applicant was injured in a motor vehicle accident and applied for a determination of catastrophic impairment.

The insurer denied the application, and the applicant subsequently submitted two more applications for the same determination more than two years later, arguing that a change in the law permitted re-application.

The insurer argued the arbitration was time-barred under s. 281(5) of the Insurance Act.

The arbitrator held that the two-year limitation period applies to catastrophic impairment determinations and runs from the date of a valid refusal.

Because the applicant's subsequent applications were based on the same criteria and did not demonstrate a change in condition, the limitation period was not reset.

The application for arbitration was dismissed as time-barred.

The Court of Appeal issued an addendum and correction to a previous endorsement.

The original endorsement mistakenly stated that the appeal was allowed, when the court intended to dismiss the appeal because the underlying Rule 21 motion involved questions of fact requiring evidence.

The court amended the endorsement to dismiss both the appeal and the motion, with costs reserved to the trial judge.