9 total
Application for catastrophic impairment benefits dismissed as impairments were caused by non-accident life stressors.
The applicant sought statutory accident benefits, claiming catastrophic impairment due to physical and psychological injuries from a 2015 motor vehicle accident.
The Tribunal found that the applicant failed to prove causation on a "but for" basis, noting that his psychological impairments were primarily caused by significant non-accident life stressors, including financial ruin and family breakdown.
The Tribunal also found the applicant did not meet the threshold for catastrophic impairment under Criterion 7 (Whole Person Impairment) or Criterion 8 (Mental and Behavioural Disorders).
Consequently, the claims for a neuro-psychological examination, attendant care benefits, and housekeeping and home maintenance benefits were dismissed.
The Court of Appeal upheld the summary dismissal of a negligence claim against a driver who reasonably reacted to a sudden emergency.
The appellants appealed a summary judgment dismissing their negligence action against one defendant (Franchetto) following a motor vehicle accident.
The motion judge found Franchetto not negligent, applying the "sudden emergency" doctrine.
The Court of Appeal upheld this decision, finding no palpable and overriding error in the motion judge's conclusion that Franchetto's actions were reasonable given the sudden emergency created by the other driver.
The appeal was dismissed.
The court granted summary judgment dismissing negligence claims against a driver who reasonably reacted to a sudden head-on collision hazard.
The defendant Phillip Franchetto brought a motion for summary judgment to dismiss negligence claims against him arising from a head-on motor vehicle collision.
The plaintiffs, passengers in the other vehicle, alleged Franchetto was negligent for his speed and evasive maneuvers.
The court dismissed the motion, finding that Franchetto's actions were reasonable and did not breach the standard of care, nor were they a legal cause of the plaintiffs' injuries.
The court emphasized that expert opinions based on hindsight and counterfactuals cannot supplant the legal standard of a reasonable and prudent driver in an emergency.
Applicant deemed catastrophically impaired due to accident-related psychological disorders; attendant care and occupational therapy awarded.
The applicant sought statutory accident benefits following a 2017 motor vehicle accident, claiming she sustained a catastrophic impairment due to mental and behavioural disorders.
The Tribunal found that the accident was a necessary cause of her psychological impairments, despite a pre-existing medical history.
Applying the Guides, the Tribunal concluded the applicant suffered a marked impairment in all four spheres of functioning.
The Tribunal awarded attendant care benefits and occupational therapy services, but denied claims for certain assistive devices.
Applicant awarded post-104 IRBs due to accident-related psychological impairments preventing return to suitable employment.
The applicant was involved in a motor vehicle accident and sought post-104 income replacement benefits (IRBs) due to psychological impairments.
The respondent terminated IRBs based on insurer examinations suggesting the applicant could work in alternative roles or teach yoga.
The Tribunal found that the applicant suffered from severe depression and anxiety that prevented her from maintaining regular attendance or performing duties in a competitive, real-world setting comparable to her pre-accident career as a mental health consultant.
The Tribunal ordered the respondent to pay the post-104 IRBs with interest, but dismissed the applicant's claim for a special award under s. 10 of O. Reg. 664, finding insufficient evidence of unreasonable conduct by the insurer.
Application for medical and rehabilitation benefits dismissed as treatments were not proven reasonable and necessary.
The applicant sought medical and rehabilitation benefits following a motor vehicle accident, which the respondent insurer denied.
The applicant applied to the Licence Appeal Tribunal for resolution of the dispute, seeking payment for physiotherapy, osteopathic treatment, and orthopaedic treatment.
The Tribunal found that the applicant failed to meet her onus to show that the proposed treatments were reasonable and necessary, noting a lack of contemporaneous medical evidence supporting the need for the treatments.
The application was dismissed in its entirety.
Motion to extend time to file statement of claim granted due to lawyer inadvertence and lack of prejudice.
The plaintiff brought a motion to extend the time to file a statement of claim for personal injuries arising from a motor vehicle accident.
Although the notice of action was issued within the two-year limitation period, the statement of claim was not filed within the required 30-day period due to the plaintiff's lawyer's inadvertence and staffing issues during the COVID-19 pandemic.
The court applied the Nugent factors and found that the delay was caused by inadvertence and that the defendant suffered no prejudice, as her insurer had been promptly notified of the claim.
The motion was granted, and the plaintiff was awarded partial indemnity costs.
Reconsideration request dismissed; adjudicator did not err in finding impairments fell within the Minor Injury Guideline.
The applicant requested a reconsideration of a Tribunal decision which found that his accident-related impairments fell within the Minor Injury Guideline (MIG) and that he was not entitled to a disputed treatment plan.
The applicant argued that the adjudicator erred in law by rejecting his expert's diagnosis of chronic pain syndrome, misweighing medical evidence, and incorrectly applying sections 38(8) and 38(9) of the Statutory Accident Benefits Schedule regarding the insurer's notice of denial.
The Tribunal dismissed the reconsideration request, finding that the applicant was attempting to relitigate issues that had already failed at the initial hearing.
The Tribunal held that it had correctly weighed the medical evidence and that the insurer's notice of denial was sufficient to inform the applicant of the reasons for denial and the application of the MIG.
Insured ordered to repay $3,257.14 in overpaid income replacement benefits after returning to work.
The applicant insurer sought repayment of an income replacement benefit (IRB) in the amount of $3,257.14 from the respondent insured.
The respondent had returned to work but failed to notify the insurer, resulting in an overpayment.
The respondent did not participate in the written hearing.
The Tribunal found that the insurer met the requirements under section 52 of the Statutory Accident Benefits Schedule, having provided timely notice of the overpayment.
The Tribunal ordered the respondent to repay the IRB amount of $3,257.14 plus interest.