Dr. Getahun

The applicant insurer sought judicial review of a decision by the Director's Delegate, which allowed the insured's appeal from an arbitrator's denial of statutory accident benefits.

The Director's Delegate found that the arbitrator erred in law by failing to provide adequate reasons for denying income replacement and medical benefits.

Applying the Vavilov framework, the Divisional Court held that the standard of review was reasonableness.

The Court concluded that the Director's Delegate reasonably found the arbitrator's reasons inadequate, as they failed to address the principal evidence or explain the reasoning process.

The application for judicial review was dismissed.

The applicant was involved in a motor vehicle accident and applied for a determination of catastrophic impairment and entitlement to non-earner benefits.

The Licence Appeal Tribunal found that the applicant sustained a 55% whole person impairment due to a combination of physical and psychological impairments, meeting the threshold for catastrophic impairment under Criterion 7 of the Schedule.

The Tribunal also found that the applicant suffered a complete inability to carry on a normal life, entitling him to non-earner benefits.

The applicant sought accident benefits following a motor vehicle collision.

The respondent denied a chiropractic treatment plan and a chronic pain assessment on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been exhausted.

The applicant argued that pre-existing low back pain, psychological impairments, and chronic pain removed him from the MIG.

The Tribunal found that the applicant failed to provide compelling medical evidence of a pre-existing condition that would prevent maximal recovery within the MIG limits.

Furthermore, the Tribunal gave little weight to the orthopaedic surgeon's recording of self-reported psychological symptoms and found insufficient evidence to establish chronic pain.

As the injuries were predominantly minor and the funding limit was exhausted, the application was dismissed.

The plaintiff brought an action for damages arising from a motor vehicle accident.

Following a jury verdict awarding net general damages of $11,181.03, the court considered whether the plaintiff's injuries met the statutory threshold under the Insurance Act.

The court found that the plaintiff, whose primary role was a homemaker, sustained permanent and serious impairments to important physical and psychological functions, including PTSD and depression.

The court ruled that the injuries met the threshold and dismissed the defendant's motion.

The appellant appealed a trial judgment dismissing her negligence action arising from an injury sustained while practicing long-jump techniques at a secondary school.

The trial judge found that the school board and its employees did not breach their duty of care and met the standard of a prudent parent.

The appellant raised eleven grounds of appeal challenging the trial judge's credibility assessments, factual findings, and treatment of expert evidence.

The Court of Appeal upheld the trial judgment, finding no palpable and overriding error and affirming the trial judge's comprehensive reasons and conclusions.

The appeal was dismissed with costs awarded to the respondents.

The defendants brought a motion for a declaration that the plaintiff's injuries from an automobile accident did not meet the verbal threshold under the Insurance Act, which would bar recovery for non-pecuniary general damages and healthcare expenses.

The court found that the plaintiff, Balbir Mann, failed to prove on a balance of probabilities that he suffered a permanent, serious impairment of an important bodily function.

The plaintiff's credibility as a historian was significantly undermined by inconsistencies in his testimony, reports to doctors, and surveillance video footage.

Consequently, the expert opinions based on his unreliable self-reports were also deemed unreliable.

The court allowed the defendants' motion, dismissing the plaintiff's action for non-pecuniary general damages and healthcare expenses.

The defendants in a motor vehicle accident tort action brought a motion to compel the plaintiff to attend orthopaedic and neurological defence medical examinations.

The plaintiff opposed the motion, arguing that the defendants were issue estopped because the Licence Appeal Tribunal had already found her to be catastrophically impaired under the Statutory Accident Benefits Schedule (SABS).

The court rejected the issue estoppel argument, noting the different thresholds between SABS and tort actions and the 'firewall' between the two processes.

The court granted the orthopaedic examination as the plaintiff had put her physical condition in issue, but denied the neurological examination because the plaintiff had not claimed neurological impairment.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits (IRB) and medical benefits.

The insurer terminated the IRB claim, alleging the applicant wilfully misrepresented her employment status by working after the accident while claiming to be disabled.

The arbitrator found that while the applicant did wilfully misrepresent that she had not worked on several specific days, the misrepresentation was not 'material' enough to justify terminating all benefits, as the insurer could simply deduct the earnings from the IRB.

The arbitrator awarded the IRB (less a deduction for days worked) and a medical benefit, but denied an attendant care assessment.

A special award of $2,000 was also ordered against the insurer for unreasonably withholding benefits, though the amount was tempered due to the applicant's own deceitful conduct.

The applicant sought statutory accident benefits, including a non-earner benefit and medical benefits, following a motor vehicle accident.

The respondent denied the benefits on the basis that the applicant's impairments were caused by pre-existing spinal degeneration rather than the accident.

The Tribunal found that the applicant failed to establish on a balance of probabilities that the accident caused her current impairments, noting that her medical records showed extensive pre-existing spinal issues and that her post-accident complaints were inconsistent with her self-reports to expert assessors.

The appeal was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physical therapy and a psychological assessment.

The insurer denied the physical therapy plans, arguing the applicant's impairments were pre-existing and fell within the Minor Injury Guideline.

The arbitrator preferred the evidence of the applicant's orthopaedic surgeon, finding the accident exacerbated pre-existing degenerative conditions in the low back and right knee, warranting further physical therapy outside the Minor Injury Guideline.

Three of the four physical therapy plans were approved, while one was denied because it was retroactively altered.

The arbitrator also denied the unapproved balance for a psychological assessment, finding the services were provided by an unregulated counsellor and billed improperly.

The applicant was awarded interest on overdue benefits, and no costs were ordered.

The applicant, an elderly pedestrian who was struck by a motor vehicle in a parking lot, applied for statutory accident benefits including non-earner benefits, attendant care benefits, and medical/rehabilitation benefits.

The adjudicator dismissed the application in its entirety.

The adjudicator found that the applicant failed to prove she suffered a complete inability to carry on a normal life, noting inconsistencies in her self-reporting and relying on insurer's examinations that found no objective impairment preventing her pre-accident activities.

Claims for attendant care and medical benefits were similarly dismissed due to a lack of persuasive medical evidence and inconsistencies in the applicant's submitted treatment plans.

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

The respondent denied payment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant's psychological impairments, specifically Somatic Symptom Disorder and Posttraumatic Stress Disorder, took his injuries outside the MIG.

The Tribunal ordered the respondent to pay for a chronic pain assessment and two treatment plans for physiotherapy and chiropractic services, finding them reasonable and necessary.

Two other physiotherapy treatment plans were denied.

Interest was awarded on the overdue payments.

The applicant was injured in a motor vehicle accident and received an Income Replacement Benefit (IRB) until the respondent insurer terminated it, claiming the applicant could return to work.

The applicant sought reinstatement of the IRB, arguing he was physically and psychologically incapable of working.

The Tribunal found that while the applicant's physical injuries had healed, the accident materially worsened his pre-existing depression and caused severe post-traumatic stress disorder.

Preferring the evidence of the applicant's treating psychologists over the insurer's assessor, the Tribunal concluded the applicant suffered a complete inability to engage in any suitable employment.

The Tribunal ordered the respondent to pay the outstanding IRB amounts with interest.

The defendant brought a motion for summary judgment to dismiss the plaintiff's personal injury claim arising from a motor vehicle accident, arguing it was statute-barred.

The intervener, the plaintiff's former counsel, opposed the motion, while the plaintiff took no position.

The court determined that the limitation period began to run when the plaintiff's injuries could reasonably qualify as "permanent serious impairment" under the Insurance Act, which was found to be upon receipt of an independent medical examination report in November 2010, or at the latest, when the first statement of claim was issued in December 2011.

As the action against the correct defendant was commenced in December 2014, it was outside the two-year limitation period.

The defendant's motion for summary judgment was granted, dismissing the plaintiff's claim.

The plaintiff, a high school student, sued her coach, principal, and school board for negligence after sustaining a knee injury during track and field practice.

The court found that the defendants met the standard of care of a careful and prudent parent, and that the plaintiff's current physical condition and occupational aspirations were not causally related to the injury.

The plaintiff's claim was dismissed.