Gus Triantafillopoulos

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 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.

The applicant sought interest and an award under O. Reg. 664 for a $2,486.00 treatment plan that the respondent insurer failed to respond to for over two and a half years.

The Tribunal found the insurer breached s. 38(8) of the Schedule and unreasonably withheld and delayed payment.

The Tribunal ordered the insurer to pay interest on the overdue benefit and a 40% award, noting the insurer's stubborn and unyielding conduct in failing to correct its error once discovered.

The applicant, a self-employed real estate agent, sought dispute resolution for statutory accident benefits following a motor vehicle accident.

The Tribunal determined the applicant's weekly income replacement benefit (IRB) must account for passive income earned from real estate deals closing during the disputed periods, awarding $2,685.71.

The Tribunal denied the claims for a $2,900 psychological assessment and $1,320.77 for psychological treatment, finding them not reasonable and necessary as previous approved treatments were not utilized and the treatment plan included impermissible administrative costs.

Interest was awarded on the overdue IRB, but a claim for an award under Regulation 664 was dismissed.

The defendant Ryder Truck Rental Canada Ltd. brought a motion in writing to lift a stay of proceedings and dismiss the action in its entirety without costs.

The plaintiffs had resolved their claim with the co-defendant insurer and elected not to proceed against the remaining defendants.

The court found that a previous noting in default of the individual defendant while the stay was in place was invalid, but that noting in default was not required to dismiss the action.

The court lifted the stay for the sole purpose of dismissing the action without costs on consent of the participating parties.

The defendant Ryder Truck Rental requested an order lifting a previously imposed stay of proceedings and dismissing the action on consent.

The court noted that the defendant Minassian had been noted in default after the stay order was issued, and that a noting in default obtained during a stay should not be given effect.

The court directed that any request to lift the stay and dismiss the action must be made by way of a formal motion in writing on notice to all parties.

The respondent insurer requested a reconsideration of a Licence Appeal Tribunal decision regarding the applicant's entitlement to income replacement benefits and interest following a motor vehicle accident.

The Vice-Chair found that the original adjudicator violated Rule 18.2 by issuing an unclear order regarding the timeframe for income replacement benefits and by making an error of law in determining that interest on medical benefits was payable from the date the treatment plan was submitted rather than when the expense was incurred.

The request for reconsideration was granted in part, and the decision was referred back to the original adjudicator for amendment.

The applicant sought statutory accident benefits following an incident in a gym parking lot where he was involved in a physical altercation with the gym manager.

The applicant alleged he was pushed into his vehicle and sustained injuries.

The Tribunal held a preliminary issue hearing to determine if the incident met the definition of an 'accident' under section 3(1) of the Statutory Accident Benefits Schedule.

Applying the two-part purpose and causation test, the Tribunal found that the assault was an intervening act that broke the chain of causation.

The incident did not arise out of the ordinary use or operation of an automobile, and the vehicle was not the direct cause of the injuries.

The application was dismissed.

The applicant sought payment for an accounting report prepared to calculate her Income Replacement Benefits (IRBs), as well as interest on overdue IRB payments and an award for unreasonable delay.

The Licence Appeal Tribunal found that the accounting report was not reasonable and necessary because the IRB calculation was simple and the dispute arose from the applicant's failure to provide accurate income information.

The Tribunal dismissed the claim for the report and the award, but allowed the claim for interest on the overdue IRB payments, noting that the interest provision is a no-fault provision.

The applicant was injured in a motor vehicle accident and sought enhanced statutory accident benefits, claiming a catastrophic impairment based on three Glasgow Coma Scale (GCS) scores of 9.

The insurer denied the claim, arguing the applicant sustained only a minor injury and that the GCS scores were not caused by a brain impairment resulting from the accident.

The arbitrator found that the applicant sustained a concussion, which qualifies as a brain impairment, and that the impairment was caused by the accident.

Applying the Divisional Court's ruling in Hodges, the arbitrator held that the GCS score is conclusive and an inquiry into the seriousness of the brain injury is irrelevant.

The arbitrator concluded that the applicant sustained a catastrophic impairment within the meaning of the Schedule.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits, which the insurer denied.

The insurer raised a preliminary issue that the applicant's arbitration request was filed beyond the two-year limitation period.

On the morning of the preliminary issue hearing, the applicant's counsel requested an adjournment because the applicant had travelled to Germany and could not attend.

The insurer opposed the adjournment and moved to dismiss the arbitration.

The arbitrator granted the adjournment, noting it was the applicant's first request and her life was in transition, but ordered the hearing peremptory to the applicant and awarded $1,500 in costs to the insurer.

The motion to dismiss was denied as it would severely prejudice the applicant's rights without a hearing.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to caregiver, housekeeping, and medical benefits.

The insurer denied the claims on the basis that the applicant's impairments were not caused by the accident.

The arbitrator found that the applicant failed to disclose pre-existing neck and shoulder complaints to his treating practitioners and assessors, and did not report the accident to his family doctor for several months.

The arbitrator concluded that the applicant's impairments were likely caused by pre-existing pathology and the physical strain of caring for his ailing wife, rather than the accident.

The claims were dismissed, save for a small outstanding balance on a previously approved treatment plan.

The applicant's representative requested a last-minute adjournment of an arbitration hearing because he was out of the country.

The arbitrator found that the representative's delay and failure to manage his travel plans caused the insurer to incur expenses without reasonable cause.

Pursuant to section 282(11.2) of the Insurance Act, the representative was ordered to personally pay $250 to the insurer for costs thrown away due to the adjournment.