Jono Schneider

The insured requested a reconsideration of a Licence Appeal Tribunal decision that ordered her to repay Income Replacement Benefits (IRBs) and denied her claims for physiotherapy treatment plans.

The adjudicator granted the reconsideration in part, finding that the original hearing adjudicator committed a material breach of procedural fairness by excluding the insured's reply submissions.

Furthermore, the original decision contained errors of law by incorrectly concluding that non-compliance with section 33 of the Schedule allowed the insurer to claim repayment for past paid IRBs, and by failing to consider the insurer's compliance with section 38 and the insured's expert medical evidence regarding the treatment plans.

The substantive issues were remitted for a new hearing.

The defendants in a personal injury action arising from a motor vehicle accident brought a motion for the production of the plaintiff's tax returns, employment file from a non-party, and a third year of pre-accident medical records.

The plaintiff consented to producing tax returns but opposed the request for the additional medical records.

The court granted the motion, finding that three years of pre-accident medical records is the baseline standard in personal injury actions and proportional under the Rules of Civil Procedure.

The court also ordered the non-party employer to produce the employment file, as it was relevant to the damages claim and necessary for a fair hearing.

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

The matter proceeded to a written hearing before the Licence Appeal Tribunal.

The applicant failed to file any written submissions or evidence by the deadline.

The Tribunal proceeded with the hearing and found that the applicant failed to meet her burden of demonstrating entitlement to the disputed treatment plans, an award, or interest.

The application was dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied entitlement to two physiotherapy treatment plans, an orthopedic assessment, and an award.

The adjudicator granted the reconsideration in part, finding an error of fact regarding the January 12, 2024 physiotherapy treatment plan because the initial decision overlooked material clinical notes and records supporting the plan.

The applicant was found entitled to this plan plus interest.

The reconsideration requests for the other treatment plans and the award were dismissed, as the applicant had not provided submissions on them at the initial hearing or failed to establish an error.

The respondent's request for costs was denied because the reconsideration request was partially successful and not frivolous.

The applicant sought income replacement benefits (IRBs) and a special award following a motor vehicle accident.

Prior to the hearing, the respondent paid the outstanding IRBs with interest up to July 29, 2025, and subsequently terminated the benefit.

The Tribunal found the post-July 2025 termination was not properly in dispute.

The Tribunal dismissed the applicant's claim for a special award under s. 10 of O. Reg. 664, finding the respondent's delay in payment was not unreasonable as it was awaiting necessary Employment Insurance documentation.

Both parties' requests for costs were denied.

The applicant sought payment for a neurological assessment following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant had already been assessed by multiple neurologists and a neurosurgeon through OHIP, and that the proposed assessment plan lacked sufficient information to demonstrate its reasonableness or necessity.

The application for the assessment, along with claims for interest and an award, was dismissed.

The applicant sought increased income replacement benefits (IRBs), interest, and a special award following a motor vehicle accident.

The Tribunal found that because the applicant was both employed and self-employed, he could not calculate his gross annual employment income based solely on the four weeks prior to the accident under s. 4(2)1 of the Schedule.

The claim for increased IRBs and further interest was dismissed.

However, the Tribunal granted a 10% special award under s. 10 of Reg. 664, finding that the respondent unreasonably delayed calculating and paying the IRBs for several months without a compelling explanation.

The insurer applied for repayment of $10,571.43 in income replacement benefits (IRBs) paid to the insured person, while the insured person sought entitlement to various treatment plans and an award for unreasonable delay.

The Tribunal found that the insurer provided a valid and timely repayment notice and was entitled to the full repayment amount, as the insured person had returned to work earning her pre-accident wages and failed to comply with section 33 requests for income information.

The Tribunal denied the insured person's claims for physiotherapy and medication, finding insufficient evidence of reasonableness and necessity, but approved a neurology assessment plan based on persistent post-concussion symptoms.

Claims for an award and costs were dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy and an orthopaedic assessment.

The respondent denied the benefits, initially relying on the Minor Injury Guideline (MIG), though the MIG was later conceded.

The Tribunal found the applicant entitled to the first physiotherapy treatment plan based on supportive clinical notes from his family physician.

However, the Tribunal dismissed the claims for subsequent physiotherapy plans and the orthopaedic assessment due to a lack of medical evidence demonstrating they were reasonable and necessary.

The claim for a special award under s. 10 of O. Reg. 664 was dismissed as the insurer's conduct did not rise to the level of being unreasonable, given the applicant's failure to provide requested medical documentation.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision denying his claim for statutory accident benefits.

The applicant argued the Tribunal erred in fact by finding he had not filed any evidence.

The Vice-Chair granted the reconsideration request, finding that the applicant had indeed filed a 1008-page document brief prior to the deadline.

However, upon reconsidering the matter, the Vice-Chair confirmed the original decision.

Because the applicant had only filed a document brief without any accompanying written submissions to explain how the evidence supported his claim, he failed to meet his evidentiary burden.

The Tribunal declined to sift through the voluminous record to make the applicant's case for him.

The applicant requested a reconsideration of a decision denying her entitlement to statutory accident benefits.

The original adjudicator dismissed the claim because the applicant failed to provide written submissions, despite filing document briefs.

The applicant argued this was an error of fact and a breach of procedural fairness.

The Vice-Chair dismissed the reconsideration request, finding that the adjudicator correctly recognized the document briefs and properly concluded that documentary evidence alone, without accompanying submissions to point out key evidence, is insufficient to establish entitlement to benefits.

The applicant requested a reconsideration of a previous Licence Appeal Tribunal decision that denied various treatment plans, interest, and an award.

The applicant argued the Tribunal acted outside its jurisdiction by removing undisputed issues and made errors of law or fact in its analysis of the evidence.

The Tribunal dismissed the request, finding that the applicant failed to meet the high threshold for reconsideration and was attempting to re-litigate the original decision.

The applicant sought entitlement to various treatment plans and an award under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The matter proceeded to a written hearing, but the applicant failed to file any written submissions or point to evidence supporting her claims, despite filing a document brief.

The adjudicator found the applicant failed to meet her burden of proof and dismissed the claims.

The respondent's request for costs was also denied, as the applicant's failure to file submissions did not amount to serious misconduct.

The applicant sought entitlement to several treatment plans for physiotherapy and an occupational therapy assessment following a motor vehicle accident.

The insurer denied the plans, but the applicant argued the denial notices were defective.

The Tribunal found that the insurer's denial notices failed to comply with the strict requirements of s. 38(8) of the Schedule, as they lacked sufficient medical reasons and failed to clearly explain the Minor Injury Guideline.

Consequently, under s. 38(11), the treatment plans were payable.

The applicant's claim for a special award was dismissed due to insufficient evidence of unreasonable conduct by the insurer.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to an in-home assessment and five chiropractic treatment plans.

The respondent had removed the applicant from the Minor Injury Guideline (MIG) prior to the hearing.

The Tribunal found that the applicant failed to prove on a balance of probabilities that the disputed treatment plans were reasonable and necessary, noting that the medical evidence did not adequately explain why five duplicative chiropractic plans were required.

The application was dismissed, and claims for interest and an award were consequently denied.

The applicant sought accident benefits following a motor vehicle accident, arguing that a pre-existing neck condition warranted removal from the Minor Injury Guideline (MIG).

The Tribunal found the applicant's medical evidence, consisting primarily of a checkmark on a faxed note from his family physician, insufficient to prove the pre-existing condition precluded recovery within the MIG.

Relying on a comprehensive independent medical examination, the Tribunal concluded the injuries remained predominantly minor.

The claims for a physiotherapy treatment plan, an award for unreasonable delay, and interest were dismissed.

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

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued she should be removed from the MIG due to a pre-existing condition of mild scoliosis and chronic pain with a functional impairment.

The Tribunal found that the applicant failed to provide compelling medical evidence that her pre-existing condition precluded recovery within the MIG.

Furthermore, applying the AMA Guidelines, the Tribunal concluded the applicant did not suffer from chronic pain with a functional impairment, as she remained independent in her activities of daily living and continued to work.

As the applicant remained within the MIG limit, the disputed treatment plans were not assessed for reasonableness and necessity.

The application was dismissed.

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

At the outset of the hearing, the respondent agreed to fund the disputed medical benefits and income replacement benefits.

The hearing proceeded on the issues of interest, a special award, and costs.

The Tribunal found that the respondent unreasonably delayed the payment of benefits by failing to make a determination after receiving requested disclosure and completing an examination under oath, ordering a 15% special award.

Interest was awarded on the overdue benefits, but the applicant's request for costs was denied as the respondent's conduct did not meet the high threshold of being unreasonable, frivolous, vexatious, or in bad faith.

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

The matter proceeded to a written hearing, but neither party filed submissions or evidence despite multiple notices from the Tribunal.

The Tribunal applied section 7(2) of the Statutory Powers Procedure Act to proceed without the applicant's participation.

Finding that the applicant failed to meet his evidentiary burden to demonstrate entitlement to the disputed benefits, the Tribunal dismissed the application.

The defendant brought a motion to compel the plaintiff to answer an outstanding undertaking and four refused questions from discovery.

The court ordered the plaintiff to produce an accident benefits file from a prior accident, rejecting the plaintiff's argument that it was irrelevant.

The court also ordered the production of redacted bank records and accountant's files for three years pre-accident, finding them relevant to the plaintiff's income loss claim given inconsistencies in reported earnings.

However, the court refused to compel answers regarding a statement given by the plaintiff to their insurance company after the accident, applying the principle that such information could be obtained through direct questioning during discovery, similar to Sangaralingam v. Sinnathurai.

Costs were not awarded due to divided success.