Derek Ross Greenside

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

The respondent denied several treatment plans and a non-earner benefit, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered from chronic pain with functional impairment, removing him from the MIG.

The Tribunal approved treatment plans for physiotherapy, a psychological assessment, and a chronic pain assessment, but denied a treatment plan for psychological services.

The claim for a non-earner benefit was barred because the applicant failed to submit an Election of Benefits form (OCF-10).

A claim for an award under s. 10 of O. Reg. 664 was dismissed.

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

The respondent insurer denied several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant sustained chronic pain and psychological impairments (including PTSD and driving phobia) that removed her from the MIG.

The Tribunal preferred the evidence of the applicant's treating practitioners and in-person assessors over the insurer's paper reviews and examinations.

The applicant was awarded all disputed medical and rehabilitation benefits, totaling over $10,000, plus interest on overdue payments.

The applicant sought a determination that she sustained a catastrophic impairment under Criterion 8 of the Schedule following a motor vehicle accident.

The applicant claimed marked impairments in activities of daily living, social functioning, and concentration, persistence, and pace due to mental health issues triggered by the accident.

The Tribunal found the applicant to be an unreliable historian and noted extensive pre-accident medical records documenting similar physical and psychological impairments.

The Tribunal concluded the applicant failed to prove she suffered three marked impairments as a result of the accident and dismissed the application.

The appellant appealed a Licence Appeal Tribunal decision finding he had not suffered a catastrophic impairment following a motor vehicle accident.

The appellant argued the adjudicator erred in her treatment of expert evidence, violated procedural fairness by questioning an expert, misapplied the temporal requirements for assessments under the Statutory Accident Benefits Schedule, and used an overly restrictive causation test.

The Divisional Court dismissed the appeal, finding no errors of law, as the adjudicator properly applied a flexible approach to the timing of assessments and correctly considered impairments caused by the traumatic brain injury.

The applicant sought to rescind a settlement agreement entered into with the respondent insurer regarding statutory accident benefits following a 2007 motor vehicle accident.

The applicant argued the settlement was not full and final and did not comply with Regulation 664.

The Tribunal found the settlement was valid and governed by Regulation 664.

The Tribunal dismissed the application, holding that the applicant was not entitled to rescind the settlement because he failed to provide written notice of rescission and did not repay the settlement funds as required by section 9.1(7) of Regulation 664.

The appellant sought judicial review and appealed a decision of the Licence Appeal Tribunal (LAT) which found her accident benefits claim statute-barred.

The Divisional Court dismissed both, stating judicial review was only available in "exceptional circumstances" given the statutory appeal right.

The Court of Appeal dismissed the further appeal, clarifying that while judicial review is always available, it is a discretionary remedy and will only be exercised in rare cases where alternative remedies (like reconsideration and statutory appeal) are inadequate.

The Court affirmed the LAT's finding on the limitation period as reasonable and provided guidance on handling concurrent appeal and judicial review proceedings.

The applicant applied for dispute resolution regarding statutory accident benefits following a motor vehicle accident.

A written hearing was scheduled, but the applicant failed to file written submissions by the deadline.

Despite being given an extension to re-file an adjournment request, the applicant did not do so and provided no explanation.

The Tribunal found that the applicant had abandoned her claim and dismissed the application pursuant to Rule 3.4 of the Tribunal Rules.

This endorsement addresses motions for leave to intervene in an appeal concerning the scope of judicial review when a limited statutory right of appeal exists.

The Court of Appeal for Ontario granted leave to intervene to the Advocacy Centre for Tenants Ontario (ACTO) and the Income Security Advocacy Centre (ISAC), finding they offered unique perspectives on the implications of the Divisional Court's decision for other statutory schemes.

The motion for leave to intervene by the Ontario Trial Lawyers Association (OTLA) was dismissed as its submissions were largely duplicative of the appellant's and granting a third intervener would be unfair to the respondent.

The applicant sought a determination of catastrophic impairment under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The central issue was whether the applicant's traumatic brain injury resulted in a Severe Disability or Lower Moderate Disability under the Extended Glasgow Outcome Scale (GOS-E).

The Tribunal found that the GOS-E assessment must be conducted by a physician or neuropsychologist, not an occupational therapist, and must isolate the effects of the brain injury from other physical or psychological injuries.

Preferring the evidence of the respondent's neuropsychologist, the Tribunal concluded the applicant sustained only a mild traumatic brain injury and did not meet the threshold for catastrophic impairment.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs) for both the pre-104 week and post-104 week periods.

The respondent insurer denied the benefits based on multidisciplinary assessments concluding the applicant suffered minor injuries and could return to work.

The Tribunal found that the applicant was entitled to IRBs for a limited period from November 1, 2017, to December 31, 2017, as her injuries temporarily prevented her from working.

However, the Tribunal dismissed the claim for ongoing IRBs, noting that the applicant had retrained as a personal support worker, completed practicums, and travelled internationally, demonstrating she no longer suffered a substantial or complete inability to work.

The claim for a special award was dismissed, but interest was awarded on the overdue benefits for the limited period.

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

The insurer determined the injuries fell within the Minor Injury Guideline (MIG) and denied further treatment plans.

The Tribunal found the applicant's injuries were predominantly minor and subject to the MIG.

However, the insurer failed to provide a timely denial notice for a physical therapy treatment plan under s. 38(8) of the Schedule.

As a result, the insurer was ordered to pay $168.00 for expenses incurred during the 'shall pay' period under s. 38(11).

The remaining claims for chiropractic treatment and a psychological assessment were dismissed as they were validly denied and the MIG limit was exhausted.

The applicant tripped and fell while walking up her driveway, striking her face against the rear bumper of her parked SUV.

She sought statutory accident benefits, which the respondent insurer denied on the basis that the incident did not constitute an 'accident' under s. 3(1) of the Schedule.

The Tribunal applied the purpose and causation tests, finding that a parked vehicle falls within the ordinary scope of use and operation, and that the vehicle was the direct cause of the applicant's injuries.

The Tribunal concluded that the incident met the definition of an accident and directed the parties to schedule a case conference.

The appellant sought to appeal and judicially review a Licence Appeal Tribunal (LAT) decision which found her claims for statutory accident benefits were statute-barred.

The Divisional Court dismissed the statutory appeal, finding that the LAT's determination of whether the insurer's denial letter was clear and unequivocal was a question of mixed fact and law, not an extricable question of law.

The court also declined to exercise its discretion to hear the judicial review application, holding that judicial review of a LAT decision on statutory accident benefits is only available in exceptional circumstances, given the legislative intent to limit appeals to questions of law.

In an automobile insurance priority dispute, the appellant insurer sought production of communications between two other insurers regarding a section 10 notice.

The appellant argued the notice was part of an inappropriate scheme to circumvent the 90-day notice requirement.

The arbitrator dismissed the motion, finding the communications irrelevant as the initial notice was made in good faith.

On appeal, the Superior Court of Justice found no palpable and overriding error in the arbitrator's decision and dismissed the appeal.

The applicant requested a reconsideration of a preliminary issue decision which found her claims for income replacement benefits and housekeeping benefits were statute-barred by the two-year limitation period.

The applicant argued the Tribunal erred in its findings regarding the insurer's denial letters and the inclusion of the Right to Dispute Form.

The Adjudicator dismissed the reconsideration request, affirming that the January 7, 2011 correspondence constituted a valid denial that included the required dispute resolution form, and therefore the limitation period had lapsed before the application was filed.

The applicant sought to amend a $5,000 expenses award in favour of the insurer following an appeal of an arbitration decision regarding statutory accident benefits.

The Director's Delegate found that the applicant's success on appeal was minor compared to the total claim, and the insurer's success on a cross-appeal regarding interest rates balanced out the applicant's gains.

The original $5,000 expenses award to the insurer was upheld.

The applicant sought statutory accident benefits for chiropractic treatment following a motor vehicle accident.

The insurer denied the treatment plans, arguing the injuries were pre-existing.

The Licence Appeal Tribunal found that the insurer complied with the notice requirements under section 38(8) of the Schedule.

Applying the 'but for' test, the Tribunal concluded that the applicant's shoulder, neck, chest, and back pain pre-existed the accident and were not caused by it.

The application for benefits and interest was dismissed.

Aviva Canada Inc. sought judicial review of a FSCO Director's Delegate's order that partially rescinded an arbitration award and remitted the respondent's entitlement to non-earner benefits to a de novo hearing before a different arbitrator.

The Divisional Court dismissed Aviva's preliminary motion to admit fresh evidence, finding no exceptional circumstances.

On the merits, the Court held that the Director's Delegate reasonably concluded the Arbitrator erred in law by failing to explicitly address whether the requested insurer examination was reasonable and necessary, and by failing to address the claim for non-earner benefits prior to the scheduled examination.

The Court also found no error in remitting the matter to a new arbitrator.

The application for judicial review was dismissed.

The applicant sought income replacement and housekeeping benefits following a 2010 motor vehicle accident.

The insurer denied the benefits in 2011.

The applicant filed an application with the Licence Appeal Tribunal in 2018, more than seven years after the denial.

The Tribunal found that the insurer's denial was valid and contained the required dispute resolution information.

The Tribunal held that the application was statute-barred by the two-year limitation period under the Insurance Act and the Statutory Accident Benefits Schedule, which had lapsed in April 2014.

The application for these benefits was dismissed.

The applicant appealed an arbitrator's decision denying her claims for post-104 week income replacement benefits (IRBs), an orthotics treatment plan, and a special award under the Statutory Accident Benefits Schedule.

The Director's Delegate upheld the denial of IRBs, finding the arbitrator reasonably concluded the applicant did not suffer a complete inability to work, as medical and vocational evidence indicated she could perform sedentary or light work.

The appeal regarding the orthotics claim was allowed because the insurer's denial notice failed to set out the consequences of non-compliance, rendering it invalid.

The claim for a special award was dismissed as the insurer's conduct did not amount to unreasonably withholding payments.

The insurer's cross-appeal on the interest rate was allowed, reducing the rate from 2% to 1% in accordance with binding Divisional Court precedent.