Deborah Joan McPhail

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 moving party insurer sought to stay a FSCO Director's Delegate decision pending judicial review.

The underlying decision denied the insurer the right to recover approximately $10,000 in overpaid income replacement benefits resulting from the insured's retroactive receipt of CPP benefits.

The court granted the stay, applying the RJR-MacDonald test.

The court found a serious issue to be tried, that the insurer would suffer irreparable harm without a stay due to the insured's limited income, and that the balance of convenience favoured the insurer because the insured was already receiving her proper ongoing benefits.

The applicant sought judicial review of a Director's Delegate decision confirming an Arbitrator's finding that he was not catastrophically impaired following a motor vehicle accident.

The applicant argued the Arbitrator erred in law by relying on surveillance evidence, the applicant's presentation at the hearing, and a psychiatrist's report.

The Divisional Court dismissed the application, finding that the issues raised were questions of fact and the weighing of evidence, not errors of law, and that the Director's Delegate's decision was reasonable.

The applicant, an Ontario resident, was injured in an ATV accident in British Columbia.

He applied for statutory accident benefits in Ontario.

The insurer denied the claim on the basis that the ATV was not an 'automobile' under the Statutory Accident Benefits Schedule because it was not required to be insured in British Columbia.

The applicant sought judicial review of the FSCO Director's Delegate's decision upholding the denial.

The Divisional Court dismissed the application, finding it was reasonable to apply British Columbia legislation to determine whether the ATV required insurance, and thus the ATV did not meet the definition of an automobile.

The applicant sought judicial review of an arbitrator's decision dismissing his claim for non-earner and housekeeping benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The applicant argued that the insurer's failure to promptly respond to his application created a deemed entitlement to benefits, and that the arbitrator erred in applying causation principles given his multiple accidents.

The Divisional Court dismissed the application, finding the arbitrator reasonably concluded that the insurer's delay did not create a deemed entitlement where the insured failed to prove entitlement.

The court also upheld the arbitrator's factual findings that the applicant failed to prove the accident caused his impairments or a complete inability to carry on a normal life, noting his condition was essentially unchanged from pre-existing injuries.

The applicants sought judicial review of a FSCO Director's Delegate decision that upheld an arbitrator's exclusion of the applicant's documents and witnesses due to late service, and ordered costs personally against the applicant's lawyers.

The Divisional Court dismissed the application, finding no denial of procedural fairness in the refusal to allow an affidavit explaining the delay or in the exclusion of non-expert witnesses.

The court also held that the order for costs against the lawyers personally was reasonable given the blatant disregard of the procedural rules.

The applicant insurer sought judicial review of a Director's Delegate's appeal decision regarding a catastrophic impairment determination under the Statutory Accident Benefits Schedule.

The Delegate had overturned an arbitrator's finding that combining impairment ratings for a physical brain injury and a separate psychological disorder constituted impermissible 'double counting'.

The Delegate also remitted the issue of medication impairment back to arbitration and upheld a 4% rating for scarring.

The Divisional Court applied the reasonableness standard of review and dismissed the application, finding the Delegate's interpretation of the AMA Guides and the Schedule fell within the range of acceptable outcomes.

The applicant insurer sought judicial review of a Director's Delegate decision which held that the respondent insured was entitled to interest at 2% per month on overdue statutory accident benefits.

The insured's accident occurred after the New Regulation (O. Reg. 34/10) came into effect, but her policy was issued before that date.

The Divisional Court found the Delegate's decision unreasonable, holding that the clear wording of the New Regulation applied to all accidents occurring on or after September 1, 2010, rebutting any presumption against interference with vested rights.

The application for judicial review was granted and the Delegate's decision was quashed.

The applicant sought judicial review of a decision by the Financial Services Tribunal denying his request to retroactively purchase membership in his employer's pension plan.

The Divisional Court dismissed the application primarily because the applicant failed to exhaust his statutory right of appeal under the Pension Benefits Act and no special circumstances justified bypassing that route.

The Court also found that the application would fail on the merits, as the Tribunal's findings of fact were supported by evidence and its discretionary decision was reasonable.

The Ontario Nurses Association (ONA) brought a motion under the CCAA seeking an order to restructure the Victorian Order of Nurses for Canada (VON Canada) pension plan.

The ONA proposed transferring assets and liabilities related to VON Ontario employees into a new pension plan and sought a declaration that VON Ontario was not jointly and severally liable for any pension deficits.

The court dismissed the motion, finding that the ONA's proposal did not advance the CCAA's policy objectives of fostering going concern restructuring and avoiding liquidation.

The court also applied the business judgment rule, deferring to VON Canada's board decision to maintain the status quo, and deemed the request for a declaration on future liabilities premature and speculative.

The appellant appealed a decision of the Financial Services Tribunal revoking his mortgage broker licence.

The Tribunal found him unsuitable to remain licensed after he registered mortgages based on forged signatures without verifying the identity or consent of the client's wife.

The Divisional Court upheld the Tribunal's findings on misconduct but found the Tribunal failed to adequately consider lesser penalties than revocation, especially given the appellant's lack of prior disciplinary record.

The appeal was allowed in part, and the matter was remitted to the Tribunal to reconsider the penalty.

The appellant Superintendent of Financial Services appealed a CCAA judge's order lifting a stay of proceedings and ordering the debtor companies into bankruptcy.

The appellant argued that a deemed trust arose under the Pension Benefits Act upon the wind up of two pension plans during the CCAA proceedings, and that this trust should have priority over secured creditors.

The Court of Appeal dismissed the appeal, holding that the CCAA judge reasonably exercised his discretion to transition the proceedings to bankruptcy under the BIA, where provincial deemed trusts are rendered inoperative by the doctrine of federal paramountcy.

The appellant employer appealed decisions of the Financial Services Tribunal ordering a partial windup of its pension plan following a plant closure.

The Tribunal found that a reorganization had occurred prior to the closure and included employees laid off during that period in the windup group.

The Divisional Court dismissed the appeal, finding the Tribunal's determination that a reorganization occurred and its definition of the windup group were reasonable and supported by the evidence.

The court also upheld the Tribunal's jurisdictional rulings regarding the Superintendent's authority.

The defendant was charged under the Insurance Act of Ontario with acting as an unlicensed insurance agent.

The prosecution alleged that the defendant offered or assumed to act in the negotiation of insurance on behalf of an insurer without being a licensed agent or broker.

The defendant claimed she was merely a go-between connecting the complainant with another party and was at best a salesperson.

The court found that the defendant engaged in multiple communications, discussions, and meetings with the complainant, took copies of his driver's license and vehicle ownership, arranged for delivery of fraudulent insurance documents, and received payment.

The court rejected the defendant's credibility and found her guilty of acting as an unlicensed insurance agent in violation of section 393(23) of the Insurance Act.

The applicant insurer sought judicial review of a director's delegate's decision upholding an arbitrator's finding that the insurer's refusal to designate the respondent as catastrophically impaired did not trigger the two-year limitation period under s. 281.1(1) of the Insurance Act.

The Divisional Court held that the standard of review was reasonableness, rejecting the insurer's argument for correctness.

The Court found the director's delegate reasonably concluded that a catastrophic impairment determination is not a benefit itself, and the insurer's denial letter did not constitute a clear and unequivocal refusal of a benefit.

The application for judicial review was dismissed.

The applicant insurer sought judicial review of a FSCO Director's Delegate decision upholding an Arbitrator's finding that the respondent suffered a catastrophic impairment.

The respondent had recorded a Glasgow Coma Scale (GCS) score of 9 several days after a motor vehicle accident, which the insurer argued was confounded by medication and other injuries rather than brain impairment.

The Divisional Court dismissed the application, holding that the standard of review is reasonableness and that the SABS regulation uses the GCS score as a proxy measurement without requiring an inquiry into the patient's prognosis or the specific cause of the lowered score.

The appellant appealed a decision of the Financial Services Tribunal dismissing his claim for a pension from his former employer.

The appellant argued that the pension plan's locking-in provision was clear and entitled him to a pension, or alternatively, that the ambiguous provision should be interpreted in his favour using the contra proferentem rule.

The Divisional Court dismissed the appeal, finding the Tribunal's interpretation of the ambiguous provision was reasonable and consistent with the legislative context, and that the Tribunal made no error in declining to apply the contra proferentem principle.

In CCAA proceedings involving several affiliated corporate applicants, the monitor sought court approval of a settlement resolving competing priority claims over estate funds among pension plans, a U.S. bankruptcy trustee, secured lenders, and other creditors.

The settlement provided for partial distributions to pension beneficiaries and retired executives, with the remaining funds payable to the U.S. trustee for the bankruptcy estates of related U.S. debtors.

The court held the settlement was a reasonable and proportionate resolution that avoided costly and protracted litigation over competing statutory deemed trusts and secured claims.

A related motion by the pension plan administrator sought amendment of the salaried pension plan to implement the settlement distribution scheme.

Relying on its broad discretionary authority under s. 11 of the Companies’ Creditors Arrangement Act, the court ordered the amendment where notice had been given and no affected party objected.

On an unopposed insolvency motion under Part III of the Bankruptcy and Insolvency Act, the moving parties sought sanction of an amended consolidated proposal with substantive consolidation and a broad third-party release.

The court applied the section 59(2) reasonableness-and-benefit test, considered good faith and creditor voting support, and accepted that the proposal met statutory requirements.

The court held that third-party releases were permissible in the circumstances and interpreted the statute harmoniously with restructuring principles applied under related insolvency legislation.

Applying the Metcalfe criteria, the court found the release was necessary, supported by tangible contributions, and beneficial to creditors generally compared with bankruptcy alternatives.

The sanction order was granted.

The appellant, Hydro One Inc., appealed a Divisional Court decision upholding a Financial Services Tribunal order for a partial wind-up of its pension plan under s. 69(1)(d) of the Pension Benefits Act.

Following a corporate merger, the employment of 73 Management Compensation Plan (MCP) employees was terminated.

The Tribunal used a 'subset analysis' to determine that a 'significant number' of plan members had been terminated, comparing the number of terminated MCP employees to the total number of active MCP plan members.

The Court of Appeal dismissed the appeal, holding that s. 69(1)(d) permits a subset analysis in appropriate circumstances and that the Tribunal's application of this analysis was reasonable given that the merger intentionally targeted senior employees nearing retirement.