Douglas A. Wallace

The appellant, who suffered a catastrophic brain injury in a 1999 motor vehicle accident, appealed and sought judicial review of a Licence Appeal Tribunal decision regarding his entitlement to attendant care benefits.

The LAT had awarded a minimal monthly amount, focusing on the care actually provided by his family rather than his need for supervisory care due to his inability to respond to emergencies.

The Divisional Court allowed the appeal and granted the judicial review, finding that the adjudicator erred in law by failing to apply the correct legal test under the 1996 SABS and that the decision was unreasonable.

The matter was remitted for a new hearing before a different adjudicator.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found that the Tribunal lacked jurisdiction under s. 280 of the Insurance Act over her claim for the $45,054.65 balance of her medical and rehabilitation policy limit.

The applicant argued that the Tribunal breached procedural fairness, made errors of law and fact, and that new evidence in the form of an adjuster's file warranted reconsideration.

The adjudicator dismissed the request, finding no breach of procedural fairness as the preliminary issue was correctly identified from the Case Conference Report and Order.

The adjudicator also found no error of law or fact, noting there were no specific treatment plans in dispute at the time of the hearing, and concluded that the new evidence would not have affected the outcome.

The applicant requested reconsideration of a Tribunal decision that found her application for medical and rehabilitation benefits was barred by the two-year limitation period.

The applicant argued the adjudicator erred in fact and law by finding she had sufficient information to dispute the denials, claiming she did not receive the denials due to an outdated address.

The Tribunal dismissed the request, finding the adjudicator correctly applied the law regarding clear and unequivocal denials and properly addressed the evidence that the denials were faxed to her legal representative.

The applicant failed to establish grounds for reconsideration under Rule 18.2(b).

The applicant sought statutory accident benefits following a 2016 motor vehicle accident, including payment for two chiropractic treatment plans and the balance of her $50,000 medical and rehabilitation policy limits.

The respondent raised a preliminary issue that the claims for the treatment plans were statute-barred as the applicant failed to dispute the denials within the two-year limitation period.

The Tribunal found that the respondent's denials were clear and unequivocal, triggering the limitation period, and declined to extend the time under s. 7 of the LAT Act.

The Tribunal also dismissed the claim for the balance of the policy limits, finding no statutory authority to order such a payment without reference to a specific incurred expense.

The application was dismissed in its entirety.

The applicant sought payment of $45,054.65, representing the balance of her medical and rehabilitation policy limits following a 2014 motor vehicle accident.

The respondent insurer argued the Tribunal lacked jurisdiction because there was no specific denied benefit or treatment plan in dispute.

The adjudicator agreed, finding that under s. 280 of the Insurance Act, the Tribunal's jurisdiction is triggered only by a dispute over a denied benefit.

As the applicant had not submitted a claim for a specific benefit that was denied, there was no dispute.

The application was dismissed for lack of jurisdiction.

The applicant sought to enforce a settlement agreement for statutory accident benefits, alleging she never received the $8,000 settlement funds.

The respondent had issued the funds to the applicant's former lawyer in trust, and the cheque was cashed before the lawyer passed away.

The Licence Appeal Tribunal dismissed the application, finding it lacked jurisdiction under section 280 of the Insurance Act to order the respondent to pay the settlement funds a second time due to the alleged dishonesty of the applicant's own lawyer.

The applicant was injured when a wall from a prefabricated modular building fell on her while being loaded onto a trailer by a mobile crane.

She sought statutory accident benefits from the respondent, who insured the mobile crane.

The respondent denied the claim, arguing the crane was excluded from coverage by an OPCF-30 endorsement and was covered under a separate commercial general liability policy.

The Tribunal found that although an executed OPCF-30 was not produced, the uncontested evidence demonstrated the parties agreed to amend the contract to exclude the mobile crane from coverage when used as a crane.

Consequently, the applicant was not involved in an 'accident' under the Schedule, and the application was dismissed.

This is an appeal from an order dismissing an action, primarily sounding in defamation, under Ontario's anti-SLAPP legislation (s. 137.1 of the Courts of Justice Act).

The motion judge had dismissed the action, finding that the plaintiff (appellant) had not discharged his burden under s. 137.1(4).

The Court of Appeal found that the motion judge erred in his consideration of the respondents' defences to the defamation claims and in his weighing of the public interest in the expressions against the plaintiff's interest in proceeding.

The Court of Appeal concluded that the plaintiff had established grounds to believe the action had substantial merit and the respondents had no valid defence, and that the public interest in permitting the action to continue outweighed the public interest in protecting the impugned expressions.

The appeal was allowed, and the action was permitted to proceed in its entirety.

The applicants sought a declaration that the respondent insurer owed a duty to defend the applicant business owner in three underlying actions arising from a fire.

The fire allegedly started when the business owner used an insured truck to boost a forklift.

The respondent argued that boosting a forklift was not an ordinary use or operation of a motor vehicle.

The court applied the test for duty to defend and the test for use or operation of a motor vehicle, finding that using a truck to boost another vehicle is an ordinary and well-known activity to which motor vehicles are put.

The court declared that the respondent owed a duty to defend and ordered it to pay a one-half share of past and ongoing defence costs.

The plaintiff brought an unopposed motion for approval of a negotiated settlement and class counsel fees in a class action arising from the defendant's failure to follow public health standards in sterilizing medical instruments at its wound care clinics.

The court approved the settlement, which established a $195,000 fund to compensate the Infected Persons Class, finding it fair, reasonable, and in the best interests of the class.

The court also approved class counsel fees of $112,078.93 and a representative plaintiff honorarium of $1,500.

This endorsement addresses costs and damages following the dismissal of the plaintiff's anti-SLAPP action against several defendants.

The court applied the presumptive full indemnity costs rule under s. 137.1(7) of the Courts of Justice Act, finding no reason to depart from it given the retaliatory nature of the plaintiff's litigation and his failure to provide a costs outline for comparison.

The court fixed costs for each successful defendant, making minor reductions from the amounts claimed.

While damages were sought by two defendants under s. 137.1(9), only one was awarded, as the court found the other defendant's conduct contributed to her stress, making a damages award inappropriate.

This is an appeal concerning an insurer's duty to defend.

The appellant, found not criminally responsible for an assault due to a psychotic episode, sought coverage under his homeowner's policy.

The insurer denied coverage based on an exclusion for bodily harm arising from intentional or criminal acts.

The application judge found the negligence claim derivative of an intentional tort and that the exclusion applied.

The Court of Appeal upheld this decision, finding no error in the application judge's conclusion that the true nature of the claim was an intentional act, despite the appellant's mental state, thus affirming the applicability of the exclusion clause.

The applicant suffered a catastrophic brain injury in a 1999 motor vehicle accident.

The respondent insurer initially paid attendant care benefits (ACB) but reduced and then suspended them in November 2000 without proper notice.

The applicant sought retroactive and ongoing ACB at 24-hour care levels.

The Tribunal found that 24-hour care was not medically necessary, as the applicant had achieved a level of independent living with family support.

The Tribunal upheld the $120.40 monthly rate but ordered a top-up for two six-month periods following changes in living arrangements.

The Tribunal also awarded a 10% penalty under section 10 of Regulation 664 due to the insurer's 20-year delay in reinstating the suspended benefits, along with 2% monthly interest under the 1996 Schedule.

The applicant, who was found Not Criminally Responsible (NCR) for an aggravated assault due to schizophrenia, sought a declaration that his insurer owed a duty to defend him in a civil action brought by the victim.

The victim's claim was framed in negligence.

The court found that the negligence claim was derivative of the intentional tort of assault.

Furthermore, the court held that despite the NCR finding, the applicant's actions were both intentional and criminal within the meaning of the insurance policy's exclusion clauses.

The application was dismissed, and the insurer was found to have no duty to defend.

The applicant insurer appealed an arbitration award determining priority for Statutory Accident Benefits following a motor vehicle accident involving a catastrophically injured child.

The child's parents were separated, and the insurers disputed whether the child was principally dependent on her mother or father at the time of the accident.

The arbitrator found the child was principally dependent on her mother, utilizing a 12-month time frame for the dependency analysis rather than the 5.5-week period immediately preceding the accident when the child briefly resided with her father.

The Superior Court of Justice dismissed the appeal, finding no extricable error of law or palpable and overriding error in the arbitrator's determination of the appropriate time frame or assessment of care dependency.

The defendant in a certified class action moved for partial summary judgment and sought leave under Rule 39.02 to admit an expert psychiatric report obtained after the representative plaintiff was cross-examined on her affidavits.

The plaintiff objected, arguing the defendant split its case and failed to comply with the court-ordered timetable.

The court dismissed the motion for leave, finding the defendant provided no adequate explanation for failing to obtain the evidence earlier and that admitting the late report would cause non-compensable prejudice to the plaintiff given the agreed-upon timetable.

The applicants, two brothers who suffered severe burns in a garage explosion while replacing a vehicle's fuel pump, sought reconsideration of a decision finding their injuries did not result from an 'accident' under the Statutory Accident Benefits Schedule.

They argued the adjudicator breached procedural fairness by failing to analyze the Causation Test after finding the Purpose Test was not met, and alleged errors of fact and law regarding the vehicle's operability.

The Licence Appeal Tribunal dismissed the reconsideration request, holding there is no requirement to consider the Causation Test if the Purpose Test fails, and finding no errors of fact or law that would have led to a different conclusion.

This is an appeal of an arbitration decision concerning a priority dispute between two insurance companies, Intact and Gore Mutual, regarding statutory accident benefits for a claimant injured in an Alberta automobile accident.

The claimant, an Alberta resident, submitted an Ontario claim.

The arbitrator found Gore Mutual in greater priority under both Ontario and Alberta law and ordered reimbursement to Intact.

The Superior Court allowed the appeal, finding the arbitrator's decision on Ontario law unreasonable because the claimant was not an "insured person" under Gore Mutual's Ontario policy.

The court also held that the arbitrator exceeded jurisdiction by determining priority under Alberta law and ordering reimbursement based on it, as the arbitration agreement was limited to Ontario legislation.

The applicants, two brothers, suffered serious burn injuries from an explosion and fire while replacing the fuel pump of an inoperable vehicle in a residential garage.

They applied for statutory accident benefits, which their insurers denied on the basis that the incident was not an 'accident' under the Statutory Accident Benefits Schedule.

The Licence Appeal Tribunal held a preliminary issue hearing to determine if the incident met the definition of an accident.

Applying the purpose and causation tests, the Tribunal found that repairing an inoperable vehicle hoisted on jacks is not an ordinary and well-known activity to which automobiles are put by motorists.

The Tribunal concluded the applicants were not using the vehicle for a motoring purpose, and therefore the incident was not an accident within the meaning of the Schedule.

The applications for benefits were dismissed.

A pedestrian was catastrophically injured when struck by a vehicle whose owners had applied for automobile insurance.

The insurer issued a one-year policy but subsequently purported to rescind it based on material misrepresentation regarding one owner's driving record, sending a letter stating the coverage was "void from the inception date" approximately two months before the accident.

The injured plaintiff obtained judgment against the at-fault driver and owner but was unable to collect.

The plaintiff then sued the insurer under section 258(1) of the Insurance Act, which permits innocent third parties to recover directly from the at-fault driver's insurer.

The motion judge dismissed the action, finding the insurer had validly rescinded the contract at common law, making it void ab initio.

The Court of Appeal allowed the appeal, holding that an automobile insurer cannot rescind a contract at common law but must comply with the statutory scheme governing termination of automobile insurance contracts.