Eric K. Grossman

The plaintiffs were injured in motor vehicle accidents and sought statutory accident benefits from their insurers.

After disputes arose, the plaintiffs applied to the Financial Services Commission of Ontario (FSCO) for mediation.

When 60 days passed without a mediator being appointed, the plaintiffs commenced civil actions.

The insurers moved to strike or stay the actions, arguing that under s. 281(2) of the Insurance Act, mediation must actually be attempted and fail before an action can be brought.

The Court of Appeal dismissed the insurers' appeals, holding that the 60-day time limit in the legislation is mandatory, and mediation is deemed to have failed if not concluded within that period, freeing the insured to commence a court action.

The defendant insurer brought a motion for the determination of a question of law prior to trial regarding whether the plaintiff was entitled to simple or compound interest on arrears of weekly income benefits under s. 24(4) of the Statutory Accident Benefits Schedule (OMPP legislation).

Applying the modern principle of statutory interpretation and reviewing legislative history, including the Kruger Report, the court found that the legislature intended to impose a penalty on insurers for late payments.

The court concluded that interest payable under s. 24(4) is compound interest.

Four individuals injured in a motor vehicle accident received treatment from a chiropractor, who submitted OCF-23 forms to the appellant insurer.

The appellant argued these forms did not constitute a 'completed application for benefits' under s. 2 of O. Reg. 283/95.

The arbitrator and application judge found that the forms provided sufficient particulars to reasonably assist the insurer with processing the application and assessing the claim.

The Court of Appeal dismissed the appeal, confirming that an application need not be on a specific form to trigger the 'pay now, dispute later' obligation, provided it contains sufficient information to commence adjusting the claim.

The applicant insurer sought judicial review of an arbitrator's refusal to declare a mistrial and recuse himself from a statutory accident benefits arbitration.

The applicant argued that the arbitrator's exposure to settlement offers and off-the-record discussions during an emotional outburst by the self-represented respondent created a reasonable apprehension of bias.

The Divisional Court dismissed the application, finding that the arbitrator's knowledge of settlement information did not automatically mandate a mistrial and that his handling of the situation did not raise a reasonable apprehension of bias.

The appellant was injured in a motor vehicle accident and received disability benefits until January 1997.

In January 2000, the respondent insurer sent a letter refusing further weekly benefits, outlining the dispute resolution process, and enclosing relevant sections of the Insurance Act.

In 2007, the appellant sought to amend his statement of claim to include a claim for income replacement benefits.

The motion was dismissed on the basis that the two-year limitation period had expired.

On appeal, the court held that the insurer's letter constituted a valid refusal that triggered the limitation period, as it adequately informed the appellant of the dispute resolution process.

The respondent was injured in a motor vehicle accident and claimed an income replacement benefit under the Statutory Accident Benefits Schedule.

At the time of the accident, she had been employed for six weeks under a contract providing an annual salary of $29,000, but had only earned two weeks' pay in the four weeks prior to the accident.

The motion judge held that her gross annual income should be based on her contracted annual salary.

The Court of Appeal allowed the insurer's appeal, holding that the clear language of s. 8(3) of the Schedule required her gross annual income to be calculated by multiplying her actual gross income for the four weeks prior to the accident by 13.

The applicant sought judicial review of decisions by an Arbitrator and the Director's Delegate, which found he was not injured in an 'accident' as defined in the Statutory Accident Benefit Schedule 1996.

The applicant, a taxicab driver, was struck on the head with a rock by an assailant while in his cab.

The Arbitrator found his injuries were caused solely by the assault and not by striking any part of the vehicle, thus failing the causation test for an 'accident'.

The Divisional Court held that the standard of review was patent unreasonableness and found the Tribunal's decisions were not only reasonable but correct.

The application for judicial review was dismissed.