5 total
Catastrophic impairment claim dismissed for lack of diagnostic evidence; some rehabilitation benefits approved.
The applicant, a pedestrian struck by a vehicle, sought statutory accident benefits including a catastrophic impairment designation under Criterion 4, income replacement benefits, and various treatment plans.
The adjudicator found the applicant did not meet the test for catastrophic impairment, preferring the respondent's neurologist who concluded there was no diagnostic evidence of brain trauma from the accident.
Claims for income replacement benefits and a central vacuum system were dismissed, while treatment plans for physiotherapy and occupational therapy were approved as reasonable and necessary.
Requests for costs by both parties were denied.
The court granted the defendant's threshold motion, dismissing the plaintiff's claim for non-pecuniary damages due to unreliable expert evidence and lack of credibility.
The defendant brought a threshold motion to dismiss the plaintiff's claim for non-pecuniary damages under s. 267.5(5) of the Insurance Act, arguing her injuries did not meet the "permanent serious impairment of an important physical, mental or psychological function" threshold.
Despite a jury finding the plaintiff 60% liable and the defendant 40% liable, and awarding $40,000 in non-pecuniary damages, the court granted the defendant's motion.
The court found the plaintiff's expert medical evidence unreliable due to incomplete and inaccurate information provided by the plaintiff, and the plaintiff's own credibility was significantly undermined by inconsistencies regarding her injuries, activities, and financial situation.
Consequently, the plaintiff failed to establish that her injuries met the statutory threshold, and her claim for general damages was dismissed as statute-barred.
Plaintiff awarded damages for accident injuries, but court finds subsequent disabling stroke was an unrelated intervening event.
The plaintiff sought damages for injuries sustained in a rear-end motor vehicle accident.
Two years after the accident, the plaintiff suffered a severe stroke that left him totally disabled.
The central issue was whether the accident caused the stroke due to the plaintiff's alleged increased smoking and sedentary lifestyle following the collision.
The court found the stroke was an unrelated intervening event, relying on expert evidence that the plaintiff's heavy smoking predated the accident and his lifestyle was not sufficiently sedentary to cause a deep vein thrombosis.
The court awarded $100,000 in general damages for the accident-related chronic pain and mechanical back issues, but denied future income loss and most future care costs, as the plaintiff's total disability was caused by the non-compensable stroke.
Applicant found catastrophically impaired due to accident-related psychological impairments; special award granted against insurer.
The applicant was injured in a motor vehicle accident and sought accident benefits, claiming he sustained a catastrophic impairment.
The insurer denied the claim, arguing that any catastrophic impairment was the result of a stroke the applicant suffered two years after the accident.
The arbitrator found that the applicant's psychological impairments resulting from the accident met the threshold for catastrophic impairment, and that the accident materially contributed to the stroke.
The arbitrator awarded attendant care benefits for incurred professional services but denied them for family-provided care due to a lack of evidence of economic loss.
A special award was granted against the insurer for unreasonably withholding payments.
Pedestrian with brain injury deemed catastrophically impaired under GOS; insurer liable for special award.
The applicant, a pedestrian struck by a motor vehicle, sustained a traumatic brain injury and multiple skull fractures.
She applied for catastrophic impairment designation under the Statutory Accident Benefits Schedule based on a Glasgow Outcome Scale (GOS) score of 3 (severe disability).
The insurer denied the designation, relying on a neurologist who found no physical neurological deficits.
The arbitrator rejected the insurer's narrow interpretation of the GOS, preferring the applicant's physiatrist who considered cognitive and behavioural impairments that rendered the applicant dependent on daily support.
The arbitrator found the applicant catastrophically impaired, awarded past and ongoing attendant care benefits for services provided by her husband, approved most of the disputed medical and rehabilitation treatment plans, and held the insurer liable for a special award for unreasonably withholding benefits.