46 total
Applicant found catastrophically impaired due to psychiatric disorder; special award granted for delayed income replacement benefits.
The Applicant was injured in a motor vehicle accident and sought a determination that she sustained a catastrophic impairment due to a psychiatric disorder.
The arbitrator found that the Applicant's treating psychiatrist provided sufficient evidence of a Marked Impairment under the AMA Guidelines, satisfying the catastrophic impairment threshold.
The arbitrator also awarded a special award of $9,629.70 against the Insurer for unreasonably delaying the payment of income replacement benefits for 527 days without a valid reason, but denied a special award for medical and attendant care benefits.
Medical benefit awarded due to insurer's failure to provide medical reasons for denial; IRBs partially dismissed.
The applicant sought income replacement benefits (IRBs) and a medical benefit following a motor vehicle accident.
The Tribunal found the applicant was entitled to IRBs for the period where income documentation was provided, though the insurer had already paid the outstanding amount based on an accountant's calculation.
The claim for IRBs for the subsequent period was dismissed because the applicant failed to provide required income documentation.
The Tribunal awarded the medical benefit because the insurer failed to provide medical reasons for its denial as required by section 38(8) of the Schedule.
Interest was awarded on the overdue medical benefit.
Motion to exclude late reply submissions denied as respondent suffered no prejudice.
The respondent brought a motion to exclude the applicant's reply submissions, which were filed four days after the deadline set at the case conference.
The adjudicator dismissed the motion, finding that the respondent suffered no prejudice from the delay, no new issues were raised in the reply, and all submissions were received prior to the scheduled written hearing date.
A motion for a defence medical examination was dismissed due to the moving party's delay and resulting prejudice to the plaintiff given the imminent trial date.
The statutory third party, Wawanesa, brought a motion to compel the plaintiff to attend a defence physiatry examination.
The plaintiff opposed, arguing that leave was required under Rule 48.04 and that the motion should be denied due to various defaults by the insured and Wawanesa.
The court found that leave was not required and that Wawanesa should not be prejudiced by its insured's defaults.
However, the motion for an immediate examination was dismissed due to Wawanesa's significant delay in requesting it, which would prejudice the plaintiff given the imminent trial date and the inability to obtain a timely expert response.
The court ordered Wawanesa to produce the insurance policy and fixed costs against Wawanesa, while also stating that the plaintiff would be required to attend the examination if the trial were adjourned.
Applicant entitled to IRBs for 104 weeks but remains subject to the Minor Injury Guideline cap.
The applicant was injured in a motor vehicle accident and sought ongoing Income Replacement Benefits (IRBs), medical and rehabilitation benefits outside the Minor Injury Guideline (MIG), and a Special Award.
The arbitrator found that the applicant suffered a substantial inability to perform his pre-accident employment for the first 104 weeks, entitling him to IRBs for that period.
However, the applicant failed to prove a complete inability to engage in any suitable employment beyond the two-year mark.
The arbitrator also concluded that the applicant's injuries, including alleged chronic pain and psychological impairments, did not remove him from the MIG, as the insurer's medical evidence demonstrating no objective impairment was preferred.
The claims for additional treatment plans and a Special Award were dismissed.
Successful defendant awarded reduced partial indemnity costs after plaintiff recovered no damages.
Following a jury trial in a motor vehicle negligence action where liability was admitted but the jury found the accident caused no injuries, the defendant sought costs after the plaintiff’s action was dismissed.
The court considered the discretion under s. 131 of the Courts of Justice Act and Rule 57.01 of the Rules of Civil Procedure, as well as the effect of Rule 49 offers to settle.
The court held that Rule 49.10 did not apply because the plaintiff obtained no judgment.
Applying the principle that costs generally follow the event, the court concluded there was no misconduct justifying departure from that principle, though the plaintiff’s financial circumstances were considered in assessing quantum.
The defendant was awarded partial indemnity costs and reduced disbursements in an amount the court considered fair and reasonable.