3 total
Application for accident benefits dismissed; injuries caused by assault, not the use of an automobile.
The applicant sought statutory accident benefits after being assaulted by the driver of a vehicle and subsequently pushed out.
The respondent denied benefits on the basis that the incident did not meet the definition of an 'accident' under s. 3(1) of the Schedule.
The Tribunal applied the two-part test from Caughy and found that while the purpose test was met, the causation test was not.
The Tribunal concluded that the applicant's injuries were directly caused by an intervening act—the various assaults perpetrated by the driver—rather than the use or operation of the automobile.
The application was dismissed.
Tribunal partially approves treatment plans and orders a special award for unreasonable denial of psychological assessment.
The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of treatment plans for assistive devices, a neuropsychological assessment, and physiotherapy.
The Licence Appeal Tribunal found the applicant was entitled to a robot vacuum, miscellaneous assistive devices, and occupational therapy, but denied the costs associated with a hot tub.
The Tribunal also approved a psychological assessment and physiotherapy, finding them reasonable and necessary based on the medical evidence.
Furthermore, the Tribunal ordered the respondent to pay a special award of $440 under s. 10 of O. Reg. 664 for unreasonably denying the psychological assessment, along with interest on overdue benefits.
Augmented costs awarded where insurer refused meaningful mediation under the Insurance Act.
Following a jury trial in a negligence action arising from a rear-end collision with a motorcycle, the plaintiff obtained a damages award of $248,000.
The plaintiff subsequently sought costs including augmented costs under the Insurance Act due to the defendant insurer’s failure to make reasonable settlement efforts and to meaningfully participate in mediation.
The court found the insurer’s participation in mediation was a sham and concluded that it failed to comply with its statutory obligations under ss. 258.5 and 258.6 of the Insurance Act.
As a result, the court awarded partial indemnity costs up to the plaintiff’s settlement offer date and substantial indemnity thereafter, and augmented the costs due to the refusal to mediate.
The total costs award was $217,000 plus HST, in addition to pre-judgment interest.
