J.C. Rioux

The applicant appealed and sought judicial review of a Licence Appeal Tribunal decision granting statutory accident benefits to a passenger injured when a bus drove over a raised manhole cover.

The Divisional Court found no error in the Tribunal's findings that the manhole cover was an 'object' and the impact constituted a 'collision' under s. 268(1.1) of the Insurance Act.

The appeal and application were dismissed.

The applicant sought statutory accident benefits for a chronic pain assessment and a psychological assessment following a motor vehicle accident.

The respondent denied the treatment plans.

The Tribunal found that the applicant failed to prove on a balance of probabilities that either assessment was reasonable and necessary.

The Tribunal preferred the respondent's medical evidence, which included in-person assessments and psychometric testing, over the applicant's evidence, which relied on phone screens and lacked corroborating medical records.

The application was dismissed, and claims for a special award and interest were denied.

The applicant, who was catastrophically impaired in a motor vehicle accident, sought medical benefits to cover the monthly fees of her long-term care facility, in addition to the maximum attendant care benefits she was already receiving.

The Licence Appeal Tribunal found that the facility fees were for services consistent with attendant care, not medical or hospital expenses under section 15 of the Statutory Accident Benefits Schedule.

The application was dismissed.

The defendants, Suhaib Alekozai and Behzad Dalf-Ajresh, sought costs following a ten-day jury trial where they were entirely successful on the issues of causation and damages.

The plaintiff, Rhonda Anderson, did not make costs submissions.

The defendants requested costs on a partial indemnity basis, totaling $72,655.65.

The court, applying section 131 of the Courts of Justice Act and Rule 57.01 of the Rules of Civil Procedure, found the requested legal fees fair and reasonable given the trial's complexity and the plaintiff's initial claims versus the jury's zero damages award.

However, the court disallowed certain disbursements for lack of explanation or proportionality, ultimately awarding the defendants costs totaling $68,137.68.

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.

This is an appeal from a trial judgment that found a third party, Dennis G. K. Chu, 50% responsible for injuries sustained by Tate Moran in a motor vehicle accident, requiring him to indemnify Ottavio Fabrizi for a settlement.

The trial judge determined that Chu's intentional tortious conduct (road rage) was a "but for" cause of Fabrizi running a red light and colliding with another vehicle.

Chu appealed, arguing errors in the application of the causation test, the failure to consider Fabrizi's negligence as an intervening act, and the misapplication of the "agony of the moment" doctrine.

The Court of Appeal dismissed the appeal, affirming that contribution and indemnity under the Negligence Act can apply where one tort is intentional and the other negligent.

The court upheld the trial judge's "but for" causation finding and clarified that the "agony of the moment" doctrine is a defence to the standard of care, not a causation issue, and is not available to the party who created the emergency.

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 decision denying his request for a catastrophic impairment designation, income replacement benefits, and physiotherapy following a motor vehicle accident.

The appellant argued the Vice-Chair erred by failing to include a contingency for future surgery in his whole person impairment rating and by ignoring expert evidence.

The Divisional Court dismissed the appeal, confirming that whole person impairment is assessed based on the claimant's condition at the time of the hearing without contingencies for future deterioration or surgery.

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

The respondent insurer denied portions of treatment plans for chiropractic and physiotherapy, as well as a chronic pain assessment.

The Tribunal found that the respondent failed to provide a proper denial with medical and other reasons for the first treatment plan, triggering the consequences of s. 38(11) of the Schedule.

For the remaining treatment plan and assessment, the Tribunal preferred the applicant's medical evidence, finding the respondent's independent medical examination contained internal contradictions.

The Tribunal concluded the treatment and assessment were reasonable and necessary, ordering the respondent to pay the disputed amounts plus interest.

The applicants sought statutory accident benefits after the applicant wife slipped and fell on ice in a parking garage while walking toward her vehicle to retrieve groceries.

The respondent insurer denied the claims on the basis that the incident was not an 'accident' under the Schedule.

The Tribunal found that the incident did not meet the causation test, as the vehicle was not the dominant feature and the injuries were caused by the icy conditions of the parking garage, which constituted an intervening act.

The applications were dismissed.

The applicant sought reconsideration of a decision finding that the Canada Recovery Benefit (CRB) and Canada Emergency Response Benefit (CERB) were deductible from his Income Replacement Benefit (IRB).

Both parties agreed that the original adjudicator erred in law.

The Vice-Chair granted the reconsideration, finding that CRB/CERB are not calculated with reference to income from employment, are not 'gross employment income', and are not akin to Employment Insurance benefits.

Therefore, they are not deductible from IRBs under the Statutory Accident Benefits Schedule.

The applicant sought income replacement benefits (IRBs) and attendant care benefits (ACBs) following a motor vehicle accident.

The adjudicator found that while the applicant met the pre-104 week disability test for IRBs as a server, she failed to establish the quantum of her entitlement because she did not produce her 2016 Notice of Assessment or post-accident tax returns.

The adjudicator drew an adverse inference from this failure to produce material financial documents.

The claim for ACBs was also dismissed because the applicant provided no evidence that she had actually incurred the expenses.

The application was dismissed in its entirety.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, including Income Replacement Benefits (IRBs) and chiropractic treatment, which the respondent insurer denied.

The Licence Appeal Tribunal found that the applicant suffered a concussion and was substantially unable to perform the essential tasks of his employment, entitling him to IRBs for the first 104 weeks post-accident.

However, the applicant failed to prove a complete inability to engage in any suitable employment, precluding IRB entitlement beyond 104 weeks.

The Tribunal also held that the chiropractic treatment plan was not reasonable and necessary.

Notably, the Tribunal determined that the Canada Emergency Response Benefit (CERB) received by the applicant is tantamount to "other remuneration from employment" under the Schedule and is therefore deductible from the IRB entitlement.

The claim for an award was dismissed as the insurer's denial was not unreasonable.

The applicant sought a Non-Earner Benefit following a motor vehicle accident, claiming physical and psychological impairments, including chronic pain, alcohol dependence, and personality changes, completely prevented her from carrying on her pre-accident life of renovating houses.

The Tribunal found that the applicant remained engaged in her renovation projects post-accident and that her psychological issues, including Alcohol Use Disorder and Cluster B personality traits, pre-existed the accident.

Applying the 'but for' test, the Tribunal concluded the accident was not a necessary cause of her ongoing impairments and she did not suffer a complete inability to carry on a normal life.

The application was dismissed.

The applicant, a self-employed delivery driver, sought statutory accident benefits after a garage door fell on his head while he was picking up parcels at a commercial business.

He had parked his van, turned it off, opened the sliding door, and was walking through the garage door when it fell.

The respondent denied the claim on the basis that the incident was not an 'accident' under the Statutory Accident Benefits Schedule.

The Tribunal applied the two-part purpose and causation test.

While the purpose test was met, the Tribunal found the causation test was not satisfied.

The use of the vehicle had ended when the applicant left it to retrieve packages, and the falling garage door was an intervening act independent of the vehicle's use.

The application was dismissed.

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

The insurer denied certain medical benefits, arguing the injuries fell within the Minor Injury Guideline (MIG) and its $3,500 funding limit.

The Tribunal found the applicant suffered from chronic pain syndrome, removing him from the MIG.

The Tribunal ordered the insurer to pay for the disputed treatment plans, plus interest, and awarded the applicant 40% of the withheld amounts under section 10 of O. Reg. 664 due to the insurer's unreasonable denial without obtaining its own medical assessment.

The applicant sought statutory accident benefits following a motor vehicle accident and applied for a catastrophic impairment determination.

The insurer requested insurer's examinations (IEs) coordinated through a third-party assessment company, CanAssess.

The applicant attended the physical examinations but subsequently revoked her consent for CanAssess's participation, preventing the release of the IE reports.

The Tribunal held that revoking consent to the third-party assessment company's participation is tantamount to failing to participate in the IE process under section 44 of the Schedule.

The Tribunal permitted the application to proceed but stayed the substantive hearing until the applicant complies with the IE process.

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

The insurer denied a treatment plan for a psychological assessment and weekly non-earner benefits, taking the position that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant applied to the Licence Appeal Tribunal, arguing her injuries fell outside the MIG due to psychological impairments and chronic pain.

The Tribunal found that the applicant failed to prove on a balance of probabilities that she suffered from a psychological impairment or chronic pain arising from the accident.

The Tribunal also found the applicant was not entitled to the psychological assessment or non-earner benefits, as she failed to prove a complete inability to carry on a normal life.

The application was dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found his OCF-10 election valid and denied his claim for a non-earner benefit.

The applicant argued the Tribunal failed to consider his submissions, erred in its limitation period findings, and violated procedural fairness regarding adjuster log notes.

The adjudicator dismissed the request, finding no errors of law or fact, and noted the applicant was attempting to re-argue his case.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found that their OCF-10 election was valid and final, and that they were not entitled to a non-earner benefit.

The applicant argued the Tribunal made errors of law and fact and violated procedural fairness.

The adjudicator dismissed the request, finding that the Tribunal properly considered the evidence regarding the election, the limitation period, and the applicant's inability to carry on a normal life.

The adjudicator also found no procedural fairness violation, as the applicant was given an opportunity to cross-examine the adjuster on clarified log notes but chose not to do so.