John P. Pavoni

The respondent was involved in a motor vehicle accident and sued the uninsured at-fault driver within the two-year limitation period.

One year later, she sued her own insurer for uninsured automobile coverage.

The insurer moved for summary judgment, arguing the claim was statute-barred.

The motion judge dismissed the motion, finding a trial was required to determine when the respondent discovered her non-pecuniary damages met the threshold, and alternatively, that special circumstances justified extending the limitation period.

The Court of Appeal upheld the decision, confirming that the limitation period for non-pecuniary damages does not toll until the threshold is discovered, and agreeing that special circumstances existed without prejudice to the insurer.

The applicant, who was injured in a motor vehicle accident, applied for statutory accident benefits.

During pre-hearing discussions, the applicant exhibited signs of mental difficulty, prompting an arbitrator to order a preliminary issue hearing to determine his mental capacity to proceed in the dispute resolution process.

At the hearing, the applicant, who was self-represented, demonstrated a lack of comprehension regarding the proceedings and the insurer's submissions.

The arbitrator found that the applicant lacked the mental capacity to proceed and declared him a party under disability pursuant to Rule 10 of the Dispute Resolution Practice Code.

The arbitrator directed that the Public Guardian and Trustee be notified to take appropriate steps under the Substitute Decisions Act.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs) and rehabilitation benefits from her insurer.

She continued to work as a process server for several months post-accident before stopping due to chronic pain.

The arbitrator found that the applicant suffered a substantial inability to perform the essential tasks of her employment and awarded IRBs for 103 weeks, plus an additional 9 weeks during a crisis period when she was completely unable to engage in any employment.

The arbitrator also awarded rehabilitation benefits for a driver education instructor course, finding it was a reasonable and necessary measure to reintegrate her into the labour market.

The insurer's failure to promptly advise the applicant that a treatment plan was required precluded it from relying on her failure to submit one.

A claim for a special award was dismissed as the insurer's reliance on its medical expert was not unreasonable.

The insurer appealed a preliminary arbitration decision finding that the insured's claim for caregiver benefits was not time-barred.

The central issue was whether the two-year limitation period for applying for mediation under the Insurance Act and the SABS-1994 commenced upon the insurer's initial notice of intention to terminate benefits or upon the release of the Designated Assessment Centre (DAC) report.

The Director's Delegate held that when an insured requests a DAC assessment, the insurer's 'refusal to pay' does not occur until the DAC report is released and the insurer is authorized to stop paying benefits.

Consequently, the limitation period had not expired, and the appeal was dismissed.