Jeffrey E. Naganobu

The applicant requested a reconsideration of a decision finding she was not an insured person under the Schedule and therefore ineligible for benefits.

She argued the Tribunal violated procedural fairness and made errors of fact and law by relying on medical records and a Statement of Claim that did not mention a vehicle's involvement, rather than her sworn testimony.

The Tribunal dismissed the request, finding no breach of procedural fairness as the medical records were properly before it, and no errors of fact or law, concluding the applicant was attempting to relitigate the case.

The applicant sought statutory accident benefits after falling off her bicycle, alleging a vehicle forced her into a pothole.

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

The Tribunal found that the medical records and statement of claim did not mention the involvement of an automobile, contradicting the applicant's testimony.

The Tribunal concluded the applicant failed to meet the purpose test and dismissed the application.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that limited her attendant care benefits.

She argued the Tribunal misinterpreted section 42(5) of the Statutory Accident Benefits Schedule as a bar against retroactive claims made before submitting a Form 1, and that it failed to consider her evidence and the impossibility of earlier compliance.

The Vice-Chair dismissed the request, finding no error of law or fact, and held that the Tribunal correctly applied the statutory limits and evidentiary requirements for attendant care claims.

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

The respondent determined the injuries fell within the Minor Injury Guideline (MIG) and refused to fund a $2,594.00 chiropractic treatment plan.

The applicant argued that pre-existing chronic back pain and ongoing pain precluded recovery within the MIG.

The Tribunal found insufficient evidence that the pre-existing condition or chronic pain warranted removal from the MIG.

As the applicant had already reached the $3,500 funding limit under section 18 of the Schedule, the disputed treatment plan and claim for interest were dismissed.

The applicant, Northbridge General Insurance Corporation, appealed an arbitration decision that found it was higher in priority to pay statutory accident benefits for an individual with advanced dementia.

The arbitrator had determined that the individual was not principally dependent on her daughter for care, which would have shifted priority to the daughter's insurer, RBC General Insurance Company.

The Superior Court reviewed the arbitration decision on a standard of reasonableness, finding no error in the arbitrator's assessment of dependency, which considered the extensive care provided by a long-term care facility versus the daughter's contributions.

The appeal was dismissed.

The insurer moved for summary judgment dismissing an action for non-earner benefits brought by an insured who had previously elected and received income replacement benefits after a motor vehicle accident.

The court held that s. 36 of the Statutory Accident Benefits Schedule barred recovery of non-earner benefits for any period during which income replacement benefits had already been paid.

However, the legislation did not preclude concurrent actions seeking income replacement benefits and non-earner benefits for the period after the insurer terminated the income replacement benefits, with the ultimate entitlement to be determined at trial.

Partial summary judgment was therefore granted only for the period when income replacement benefits were actually paid.

In a personal injury action arising from a motor vehicle accident, the plaintiff moved for an order compelling the defendant to provide detailed particulars of surveillance conducted on the plaintiff.

The defendant agreed to disclose limited information but refused to provide full particulars where it did not intend to rely on the surveillance at trial.

The court held that the disclosure obligations under the Rules of Civil Procedure and the discovery process require full disclosure of surveillance particulars even if the defendant does not intend to use the evidence at trial.

Such disclosure assists parties in evaluating the strength of their cases and encourages settlement by preventing tactical surprise.

The motion was granted and the defendant was ordered to provide the requested surveillance particulars.