Gus Triantafillopoulos

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

The respondent insurer initially confined the applicant to the Minor Injury Guideline (MIG) and denied various treatment plans and income replacement benefits (IRB).

The Tribunal found the applicant's injuries were non-minor, removing her from the MIG.

The Tribunal awarded IRB for a specific period due to the insurer's non-compliance with s. 36(4) response timelines, but denied post-104 IRB.

The Tribunal approved treatment plans for physiotherapy, a psychological assessment, and a chronic pain assessment, finding them reasonable and necessary.

Notably, the Tribunal ordered a 35% special award against the insurer under s. 10 of Reg. 664, finding its conduct in adjusting the claim—including ignoring clear evidence of psychological injury and delaying IRB responses for over a year—to be imprudent, inflexible, and unyielding.

Costs were not ordered.

The applicant sought statutory accident benefits following a 2022 motor vehicle accident, claiming catastrophic impairment under Criterion 8, income replacement benefits, attendant care benefits, and various treatment plans.

The Licence Appeal Tribunal dismissed the majority of the claims, finding the applicant's self-reports of pre-accident functioning were inaccurate, as he was receiving long-term disability and Canada Pension Plan disability benefits prior to the accident.

Surveillance evidence and testimony contradicted the applicant's claims of severe social and functional isolation.

The Tribunal found the applicant did not sustain a catastrophic impairment, was not entitled to an IRB, and was only entitled to a minor portion of one treatment plan due to a late denial by the insurer.

The plaintiff brought a motion to amend the statement of claim to increase damages from $1,000,000 to $6,000,000 based on a Future Cost of Care report dated January 27, 2025, and the plaintiff's failure to recover as well as expected following amputation of his arm.

The defendants opposed the motion, arguing that the evidence from discovery did not support the increased damages and that the amendment exceeded their insurance policy limits.

The court granted the motion, finding that all factors under the applicable test favoured amendment and that exceeding policy limits does not constitute non-compensable prejudice.

Costs were awarded to the plaintiff.

The applicant, TTC Insurance Company Limited (TTCICL), sought an order extending the time to commence their appeal of a Licence Appeal Tribunal (LAT) decision and an order joining this appeal with an existing application for judicial review.

Concurrently, the LAT and the Attorney General of Ontario sought leave to intervene in the appeal.

The court granted both motions, finding that the extension of time was justified given the recent Supreme Court decision in Yatar, the short delay, lack of prejudice to the respondent, and the overall interests of justice.

Intervenor status was granted to LAT and the Attorney General, with LAT's submissions restricted to procedural and jurisdictional issues, not the merits of its decision.

The appellant appealed a Licence Appeal Tribunal (LAT) decision finding it lacked jurisdiction to award punitive damages for statutory accident benefits claims.

The appellant argued the LAT had jurisdiction or, alternatively, that section 280 of the Insurance Act was unconstitutional for eliminating punitive damages claims.

The Divisional Court dismissed the appeal, holding that the LAT's jurisdiction is strictly statutory and does not include punitive damages, as established by binding Court of Appeal precedent.

The court also rejected the constitutional challenge, finding the legislature clearly and validly removed jurisdiction over these claims from the courts to the LAT.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found she was not an 'insured person' under section 3(1) of the Statutory Accident Benefits Schedule.

The applicant argued the Tribunal made errors of law and fact, violated procedural fairness, and failed to consider priority dispute rules under O. Reg. 283/95.

The adjudicator dismissed the request, finding it was an attempt to re-litigate the case and that the priority dispute issue was outside the Tribunal's jurisdiction for this hearing.

The applicant requested a reconsideration of a preliminary issue decision which found she was statutorily entitled to income replacement benefits (IRBs) for a limited period due to the respondent's delayed response, but was otherwise barred from claiming IRBs because her impairments arose more than 104 weeks after the accident.

The applicant argued the adjudicator acted outside his jurisdiction, violated procedural fairness, and made an error of law.

The Tribunal dismissed the request, finding the adjudicator had jurisdiction to determine the remedy for the respondent's non-compliance, procedural fairness was maintained as the applicant had the opportunity to make submissions, and no error of law occurred regarding the application of section 36 of the Schedule.

The applicant sought income replacement benefits (IRBs) for psychological injuries sustained while caring for her spouse, who was catastrophically injured in a motor vehicle accident.

The insurer raised a preliminary issue that the claim was barred because the applicant failed to apply within 104 weeks of the accident.

The Tribunal found that while the applicant was generally barred from claiming IRBs because her impairment arose more than 104 weeks after the accident, the insurer's failure to respond to her application within the mandatory 10-day period under section 36 of the Schedule entitled her to IRBs for the period between her application and the insurer's eventual response.

The appellant appealed a Licence Appeal Tribunal (LAT) decision regarding his entitlement to an Income Replacement Benefit (IRB) and a special award following a motor vehicle accident.

The appellant argued the LAT erred in calculating his IRB by deducting post-accident income, failing to quantify ongoing benefits, and denying a special award for unreasonable delay.

The Divisional Court dismissed the appeal, finding the LAT correctly applied the Statutory Accident Benefits Schedule to calculate the IRB, reasonably exercised its discretion in finding the ongoing quantum issue moot, and applied the correct legal test in denying the special award.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied his claims for a non-earner benefit, medical benefits, and an award for unreasonable delay.

The applicant argued the Tribunal made errors of fact and law and violated procedural fairness, including by misapplying the rule in Browne v. Dunn and improperly weighing medical evidence.

The Tribunal found that the request was filed within the 21-day time limit but dismissed the reconsideration on the merits.

The Tribunal concluded that it had properly weighed the evidence, correctly applied the burden of proof, and made no errors of law or procedural fairness in its original decision.

The appellant appealed two decisions of the Licence Appeal Tribunal regarding statutory accident benefits.

In the first appeal, the appellant argued that an adjudicator reconsidering their own decision violated procedural fairness.

In the second appeal, the appellant argued that the Tribunal's withdrawal of a decision mistakenly rendered by an adjudicator who did not hear the oral evidence created a reasonable apprehension of bias.

The Divisional Court dismissed both appeals, finding that the Tribunal's reconsideration process is procedurally fair and that correcting an administrative error by withdrawing the mistaken decision and having the correct adjudicator issue a new one cured any procedural defect without raising a reasonable apprehension of bias.

The applicant sought reconsideration of a Licence Appeal Tribunal decision that denied his claims for treatment plans, interest, and an award under O. Reg 664 following a motor vehicle accident.

The applicant argued the Tribunal erred by not addressing the respondent's delay in removing him from the Minor Injury Guideline and by finding no objective evidence of a traumatic brain injury.

The Vice-Chair dismissed the request for reconsideration, finding that the applicant failed to identify a material error of fact or law and was merely attempting to reweigh the evidence.

The Applicant was struck by a vehicle in a parking lot, sustaining a right knee sprain and psychological injuries.

She also had a pre-existing hip condition that required surgery.

The Tribunal found that the accident did not cause or accelerate the need for hip surgery, but did cause chronic knee pain that prevented her from working.

The Applicant was awarded income replacement benefits, physiotherapy, and psychological treatment.

Claims for attendant care benefits and occupational therapy related to her hip surgery were dismissed, as was her claim for a special award.

The applicant requested a reconsideration of a Tribunal decision regarding the quantum and duration of Income Replacement Benefits (IRBs).

The applicant argued the Tribunal erred in calculating the IRB at $161.44 per week up to October 6, 2020, failing to address ongoing entitlement, and denying an award for unreasonable delay.

The adjudicator dismissed the request, finding no error of law or fact.

The Tribunal correctly relied on the applicant's own accountant's calculations under the Statutory Accident Benefits Schedule.

The issue of ongoing entitlement was deemed moot as the respondent continued to pay the benefit, and there was no basis to grant an award for unreasonable delay.

The applicant, who was 76 years old at the time of the motor vehicle accident, sought non-earner benefits, a psychological assessment, and an orthopaedic assessment.

The Licence Appeal Tribunal dismissed the application, finding that the applicant did not suffer a complete inability to carry on a normal life, as his post-accident activities were largely consistent with his pre-accident baseline.

The Tribunal also denied the psychological assessment due to a lack of supporting medical evidence from his family physician, and denied the orthopaedic assessment because it was reasonably available through OHIP.

The applicant was injured in a motor vehicle accident and sought an income replacement benefit (IRB).

The respondent conceded entitlement but delayed payment, arguing it needed more financial information to calculate the quantum for the self-employed applicant.

The Tribunal found the respondent had sufficient information and its requests for additional documents were excessive.

The Tribunal awarded the applicant $32,488.04 in IRBs up to October 6, 2020, plus $5,023.71 in interest.

The Tribunal declined to order a special award under s. 10 of O. Reg. 664, finding the respondent's reliance on its accounting expert did not meet the threshold for unreasonable behaviour.

The Tribunal also ruled on procedural motions, admitting a late preliminary expert report from the respondent but excluding a late supplementary report.

The applicant sought a special award under s. 10 of Regulation 664, alleging the respondent unreasonably delayed payment of an income replacement benefit previously ordered by the Tribunal.

The respondent had attempted to send the payment multiple times but repeatedly mailed it to incorrect addresses due to administrative errors.

The Tribunal found that while the respondent's actions indicated a lack of competence, they did not rise to the level of unreasonableness required for a special award.

The request for an award was dismissed, but the applicant was granted interest on the overdue payment pursuant to s. 51 of the Schedule.

The applicant requested a reconsideration of a previous Tribunal decision that awarded a specific amount for income replacement benefits but denied two claimed medical benefits.

The applicant argued the Tribunal failed to consider her arguments and made errors of law and fact regarding passive income deductions and the necessity of psychological assessments.

The Adjudicator dismissed the request, finding no violation of procedural fairness and concluding that the applicant was merely attempting to re-argue positions that had already been considered and rejected.

The applicant sought a special award under s. 10 of O. Reg. 664, alleging the respondent unreasonably delayed paying a settlement amount of $5,786.83 to two medical clinics.

The respondent argued the Tribunal lacked jurisdiction because the payment obligation arose from a private settlement agreement, not an entitlement under the Statutory Accident Benefits Schedule.

The Tribunal agreed it lacked jurisdiction, finding the dispute was contractual.

In the alternative, the Tribunal found the respondent's conduct did not meet the high threshold for a special award, as the delay resulted from a miscommunication regarding the submission of invoices through HCAI, rather than excessive or stubborn behaviour.

The motion was dismissed.

The applicant sought a special award under section 10 of Regulation 664, alleging the respondent unreasonably withheld or delayed payment of income replacement benefits (IRBs) following a motor vehicle accident.

The Tribunal found that the initial delay was due to the applicant's failure to provide necessary financial documentation, particularly given her self-employment status.

The Tribunal also found that the respondent's subsequent error in calculating the IRBs based on net rather than gross income, which was later corrected with interest, did not amount to excessive, imprudent, or stubborn conduct.

Both parties' requests for costs were dismissed.