Christopher John Clifford

The applicant was injured in a motorcycle accident and sought a determination of catastrophic impairment (CAT) under the Statutory Accident Benefits Schedule, along with entitlement to three treatment plans.

The Tribunal found that the applicant's combined physical and psychological impairments resulted in a 48% whole person impairment, falling short of the 55% threshold required for a CAT designation under Criterion 7.

However, the Tribunal found the disputed treatment plans for physiotherapy and psychotherapy to be reasonable and necessary, ordering the respondent to pay them up to the medical and rehabilitation policy limit, plus interest.

The plaintiff was seriously injured in a motor vehicle accident.

The defendant insurer, State Farm, brought a motion for summary judgment, arguing that the vehicle owner, Ms. Barrett, had given consent for the driver to possess the vehicle, making her liable under the Highway Traffic Act.

Ms. Barrett contended she did not give consent to drive, only to retrieve items from the car.

The court found a genuine issue for trial regarding whether giving keys to retrieve items constitutes "possession with consent" under the Highway Traffic Act, considering the driver's state and the owner's knowledge.

State Farm's motion for summary judgment was dismissed, and Ms. Barrett's request for summary judgment was also denied.

The applicant was injured in a motor vehicle accident and sought income replacement benefits and medical benefits from the insurer.

The arbitrator found the applicant suffered a substantial inability to perform the essential tasks of her employment as an educational assistant and awarded pre-104 week income replacement benefits.

However, the arbitrator dismissed the claim for post-104 week income replacement benefits, finding the applicant did not suffer a complete inability to engage in suitable employment, as she had returned to work part-time.

The arbitrator also awarded medical benefits for assistive devices, including a soaker tub, mattress, ergonomic desk, and treadmill, but denied the claim for physiotherapy and yoga.

The appellant insurer appealed an arbitrator's decision awarding interest on dependant death benefits to the respondents.

The parties agreed that the arbitrator erred in law by finding the respondents directly dependent on the deceased, rather than dependent on the deceased's spouse.

The Director's Delegate rescinded the arbitrator's orders regarding the respondents' entitlement to interest and a special award.

The issue of the respondents' entitlement to interest was remitted to arbitration for a new hearing to determine whether the respondents' own actions prevented the insurer from assessing their entitlement, which would trigger an exception to the mandatory interest provision.

The appellant insurer sought to appeal an arbitrator's preliminary decision awarding interest on dependent death benefits and directing a special award hearing.

The Director's Delegate granted leave to appeal, combined the two appeal proceedings, and stayed the arbitrator's orders regarding interest and the special award hearing pending the outcome of the appeal.

The Delegate denied requests from both parties to introduce fresh evidence on the appeal.

Following a fatal motor vehicle accident, the deceased's partner and her two children applied for spousal and dependant death benefits.

The insurer initially denied the claims due to insufficient evidence of cohabitation and dependency.

The applicants sought interest on the delayed benefit payments and arbitration expenses.

The arbitrator found that the partner was not entitled to interest because she failed to correct an error in her initial statement regarding the cohabitation date, which prevented the insurer from determining entitlement.

However, the children were awarded interest as the insurer had sufficient evidence of their dependency but delayed payment.

The applicants were also awarded their arbitration expenses, and a further hearing was ordered to determine if a special award was warranted for the delayed payments to the children.

The applicant sought a spousal death benefit following the fatal injury of her partner in a motor vehicle accident.

The insurer denied the benefit, arguing she was not a spouse under the Insurance Act, and paid the benefit amount into court pursuant to section 271 of the Act.

The insurer argued this payment transferred jurisdiction to the Superior Court of Justice, precluding arbitration.

The arbitrator held that section 271 does not interfere with an insured's unfettered right to choose the forum for dispute resolution under section 281.

The applicant was not precluded from proceeding to arbitration, and the request to stay the arbitration was denied.