Grant E. Black

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

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

The applicant applied to the Licence Appeal Tribunal, arguing that pre-existing conditions, psychological impairments, and chronic pain warranted removal from the MIG.

The Tribunal found that the applicant failed to provide compelling medical evidence to support removal from the MIG.

Consequently, the disputed treatment plans were deemed not reasonable and necessary, and the application was dismissed.

The applicant sought statutory accident benefits for chiropractic treatment following a motor vehicle accident.

The respondent denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The matter proceeded to a written hearing, but the applicant failed to file any evidence or submissions.

The Tribunal found that the applicant failed to meet his burden of proving that his injuries warranted treatment beyond the MIG or that the proposed treatment plans were reasonable and necessary.

The application was dismissed.

The respondent's request for costs was also denied, as the applicant's failure to participate did not rise to the level of unreasonable, frivolous, vexatious, or bad faith conduct.

The plaintiff brought a motion to strike the jury notice in a personal injury action arising from a motor vehicle collision, citing delays caused by the COVID-19 pandemic.

The court considered the factors for striking a jury notice before trial, including local court resources, the age of the case, and prejudice to the parties.

The court found that the plaintiff failed to demonstrate a just cause or compelling reason to strike the jury notice at this time.

The motion was dismissed, with costs awarded to the defendant.

In a costs endorsement following motions brought by co-defendants, the court held that a responding defendant was entitled to recover costs from the unsuccessful moving defendants because her participation was reasonable and directly engaged her vital interests.

The court declined to award costs against an insurer whose stay motion concerned only the contractual claim between it and the plaintiff.

Applying the principles that costs generally follow the event and must remain fair, reasonable, and proportionate, the court reduced the hours claimed and fixed costs on a partial indemnity basis.

Costs of $1,921.00 inclusive of HST were awarded against the moving co-defendants only.

The plaintiff sought to amend the statement of claim to either substitute or add the automobile insurer of the vehicle in which she was travelling when injured in a motor vehicle accident allegedly caused by an unidentified driver.

Although the claim initially named only the plaintiff’s own insurer and her son as defendants, the plaintiff had notified the proposed insurer at an early stage of a potential unidentified motorist claim and provided ongoing information regarding the claim.

The court held that the plaintiff always intended to name that insurer and that it had been on notice of the claim and therefore suffered no prejudice despite the expiry of the limitation period.

Applying Rule 5.04(2) of the Rules of Civil Procedure and s. 21(2) of the Limitations Act, 2002, the court concluded the circumstances justified amendment.

The proposed insurer was added as a defendant rather than substituted because both insurers could potentially provide coverage.

The appellant, plaintiff in a personal injury action where liability was admitted, sought a six-month adjournment of the trial because she lacked up-to-date medical reports.

The motion judge denied the request, citing delays and fading memories, which led to the action being dismissed when the appellant called no evidence.

The Court of Appeal allowed the appeal, finding the motion judge failed to consider that liability was admitted and that the respondents would suffer no non-compensable prejudice from a short adjournment.

The action was reinstated and a new trial ordered.

The deceased was killed in a motor vehicle accident.

At the time, she was separated from her husband but not divorced, and they had executed a separation agreement releasing all claims.

Her dependent daughters claimed a supplementary death benefit under the SABS, which the insurer denied on the basis that the separated husband remained a 'spouse' entitled to the primary benefit.

The arbitrator awarded the benefit to the daughters and ordered a special award against the insurer.

On appeal, the Director's Delegate confirmed the death benefit award, finding the separation agreement precluded the husband's claim, but revoked the special award because the insurer's position was based on a reasonable interpretation of a novel legal issue.

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

During the arbitration process, the insurer failed to have a representative attend a mandated pre-hearing discussion, resulting in the discussion being rescheduled.

The applicant sought $125 for expenses thrown away due to the adjournment.

The arbitrator found that the insurer's failure to have a principal participate frustrated the purpose of the pre-hearing discussion and ordered the insurer to pay $125 in legal expenses pursuant to subsection 282(11.1) of the Insurance Act.

The appellant insurer appealed an arbitration order finding that the respondent insured remained substantially unable to perform the essential tasks of her pre-accident employment as a hairdresser.

Following a motor vehicle accident, the respondent returned to work on a part-time basis, eventually working two-thirds of her pre-accident hours and earning 80% of her pre-accident income.

The Director's Delegate upheld the arbitrator's finding that despite her increased hours, the respondent's reduced capacity constituted a substantial inability to perform her essential tasks.

The appeal was dismissed and the insurer was ordered to pay income replacement benefits.

The applicant, who was six years old at the time of the motor vehicle accident, sought various statutory accident benefits including an education disability benefit, medical and rehabilitation expenses, transportation expenses, and attendant care.

The arbitrator found no objective medical evidence supporting the claims for education disability, prescription drugs, chiropractic care, rehabilitation, or attendant care, noting the applicant did not miss school and his physical activities were not limited.

The applicant was awarded transportation expenses for only two visits to his family doctor.

The arbitrator denied the applicant's request for arbitration expenses, finding the application frivolous and an abuse of process.

The insured was involved in a motor vehicle accident and claimed rehabilitation expenses.

She applied for arbitration and subsequently commenced a court action claiming the same expenses.

The insurer appealed an arbitrator's order that allowed the insured to proceed with arbitration if she amended her court action to exclude those expenses.

The Director's Delegate allowed the appeal in part, dismissing the arbitration application because the insured had elected to proceed in court and the statutory scheme precludes pursuing the same claims in both forums.

The insurer's request for reimbursement of its arbitration assessment fee under s. 282(11.2) of the Insurance Act was denied because the insurer was already seeking that relief by way of a counterclaim in the court action.

The applicant was injured in a motor vehicle accident and received statutory accident benefits.

The insurer terminated her income replacement benefits at the 104-week mark, arguing she could return to her pre-accident employment as a hairstylist.

The arbitrator found that the applicant's chronic pain substantially disabled her from performing the essential tasks of her employment, as she could only work part-time.

The arbitrator ordered the insurer to pay ongoing income replacement benefits pending a Loss of Earning Capacity offer, as well as certain medical, rehabilitation, and housekeeping benefits.

The applicant's claim for a special award was dismissed.

The applicant was injured in a motor vehicle accident and received weekly income benefits before returning to work.

The insurer terminated benefits and argued the applicant was barred from further benefits under subsection 16(2) of the Statutory Accident Benefits Schedule because she worked for more than 90 days.

The arbitrator held that subsection 16(2) does not bar an insured from receiving further benefits, but only affects the evidentiary presumption of ongoing eligibility.

The arbitrator also determined that the disability entitlement test under subsection 12(5) refers to 156 weeks of disability, and that post-accident employment income does not delay or interrupt the running of this period.

The applicant was injured in a motor vehicle accident and received income replacement benefits from the insurer.

The insurer terminated and later reinstated benefits, paying a lump sum for the outstanding period.

The applicant sought interest on the late payment, arguing the insurer had sufficient information to pay earlier.

The arbitrator found the insurer had the necessary information by April 21, 1998, and the benefits were overdue from that date.

The insurer was ordered to pay interest at 2 per cent per month compounded from April 21, 1998, to the date of payment, along with the applicant's arbitration expenses.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them, claiming she was no longer disabled.

The applicant sought ongoing benefits and vocational training costs.

The arbitrator found that the applicant's ongoing difficulties were related to pre-existing physical and psychiatric conditions, including paranoid delusions, and an unrelated subsequent ankle fracture, rather than the motor vehicle accident.

The medical evidence supporting her claim was rejected as flawed or incomplete.

The application for ongoing income replacement benefits and vocational training was dismissed.

The appellant was injured in a motor vehicle accident and sought statutory accident benefits from the respondent insurer.

The insurer denied coverage shortly after the accident, asserting the policy had been cancelled.

The appellant failed to submit a formal application for benefits within the two-year limitation period under section 22 of the Statutory Accident Benefits Schedule.

The Director's Delegate upheld the arbitrator's decision that the insurer was not estopped from relying on the limitation period, as its denial of coverage did not constitute a waiver of the application requirement.

Furthermore, the Director's Delegate confirmed that arbitrators lack the jurisdiction to grant equitable relief from forfeiture under section 129 of the Insurance Act.

The applicant, who was seriously injured in a motor vehicle accident and continued to farm, claimed the cost of a cellular telephone package as a rehabilitation benefit under section 40 of the Statutory Accident Benefits Schedule.

The insurer agreed that a cellular telephone was an appropriate rehabilitation expense but disputed the reasonableness of the $39.99 monthly package claimed by the applicant, offering instead to pay for a $19.99 package.

The arbitrator found that due to gaps in the evidence regarding the features and flat rate charges of the packages at the time of the hearing, there was insufficient evidence to conclude that the more costly package was reasonable.

The arbitrator ordered the insurer to pay $19.99 per month for the cellular telephone package.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including weekly income benefits and the cost of physiotherapy and transportation.

The insurer denied benefits, arguing that the applicant's disabilities arose from a previous work-related injury for which she was receiving WCB benefits.

The arbitrator found that the applicant's pre-existing back injury was the principal cause of her inability to work, and dismissed the claim for weekly income benefits.

However, the arbitrator found it was reasonable for the applicant to undergo an initial 12-week physiotherapy program to alleviate neck symptoms, and ordered the insurer to pay for those treatments and associated transportation costs.

The applicant was awarded 50 percent of her arbitration expenses.

State Farm appealed an arbitration decision finding it liable to pay statutory accident benefits to a claimant who was listed as a driver on her parents' policy but injured while an occupant in a vehicle insured by Pilot.

Pilot cross-appealed the finding that the claimant was not a dependant of her parents.

The Director's Delegate allowed State Farm's appeal, holding that being a listed driver does not make one an 'insured person' under the Statutory Accident Benefits Schedule for accidents in other vehicles.

The Delegate dismissed Pilot's cross-appeal, upholding the arbitrator's finding that the 18-year-old claimant was living independently and was not principally dependent on her parents for financial support.

Pilot was ordered to pay the accident benefits.

The applicant was injured in a motor vehicle accident while participating in a workers' compensation retraining program.

He claimed ongoing weekly income benefits under section 12 or 13 of the Statutory Accident Benefits Schedule.

The arbitrator found that the applicant was not employed by the Workers' Compensation Board and did not qualify under section 12.

However, the arbitrator concluded that the applicant suffered a substantial inability to perform his essential tasks as a student due to chronic pain and reflex sympathetic dystrophy, entitling him to ongoing benefits under section 13.

The claim for a special award was dismissed for lack of jurisdiction as it had not been mediated.