Kathleen O’Hara

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

The Licence Appeal Tribunal dismissed the applicant's claims for a chiropractic assessment incurred before the treatment plan was filed, and for the unapproved portions of a nutritional counselling treatment plan, finding the applicant failed to prove they were reasonable and necessary.

The Tribunal ordered the insurer to pay for various approved expenses, including an iPad and furniture, subject to the applicant providing invoices, and found no interest was owing as there were no overdue payments.

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

The insurer determined the injuries fell within the Minor Injury Guideline (MIG) and denied a physiotherapy treatment plan and certain expenses.

The applicant applied to the Licence Appeal Tribunal, arguing her injuries fell outside the MIG due to pre-existing conditions and chronic pain, and sought an award for unreasonable delay.

The Tribunal found the application was not statute-barred but concluded the applicant's injuries were minor and subject to the MIG limit.

The Tribunal dismissed the claims for the treatment plan, expenses, and the section 10 award, finding the insurer did not act unreasonably.

The applicant was injured in a motor vehicle accident and sought payment for two orthopaedic assessments under the Statutory Accident Benefits Schedule.

The insurer denied the treatment plans.

The Licence Appeal Tribunal found that the applicant failed to prove the assessments were reasonable and necessary, noting the absence of the actual treatment plans in evidence and preferring the insurer's medical evidence that the applicant suffered only soft tissue injuries.

The appeal was dismissed.

The insurer, having successfully defended the applicant's claim for accident benefits at arbitration, sought $22,820.05 in expenses.

The arbitrator considered the criteria under Rule 75.2 of the Dispute Resolution Practice Code and the principle of fairness, noting the Schedule is consumer protection legislation.

Given the applicant's limited income from Canada Pension Plan disability benefits and the uncomplicated nature of the case, the arbitrator fixed the insurer's expenses at $2,500.00 inclusive of fees, disbursements, and HST.

The applicant sought income replacement benefits and medical benefits following a motor vehicle accident.

The arbitrator found the applicant's testimony to be contradictory and lacking credibility, noting discrepancies regarding her medical treatment timeline, pre-existing injuries, and simultaneous receipt of Employment Insurance and income replacement benefits.

Relying on the medical evidence, including the insurer's orthopedic expert who found the applicant's pain was related to degenerative issues rather than the accident, the arbitrator concluded the applicant did not suffer a substantial inability to work.

All claims for benefits, a special award, and interest were dismissed.

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

Prior to a scheduled case conference, the applicant withdrew the appeal application.

The respondent subsequently brought a motion for costs, alleging the applicant acted frivolously, vexatiously, and in bad faith by misrepresenting his employment status.

The adjudicator dismissed the motion, finding that the respondent's evidence, which relied entirely on hearsay from an unidentified confidential source, was unreliable and insufficient to establish bad faith or unreasonable conduct under Rule 19.1.

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

The insurer denied the treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

At arbitration, the applicant argued his injuries, including a concussion, psychological issues, and chronic pain, removed him from the MIG.

The arbitrator found insufficient evidence of a concussion or psychological impairment but accepted the orthopaedic surgeon's diagnosis of chronic pain, which was sufficient to remove the applicant from the MIG.

The disputed treatment plans were deemed reasonable and necessary.

The arbitrator declined to order a special award, finding the insurer's reliance on the initial MIG classification and an insurer's examination was not unreasonable.

The Insurer brought a motion to stay the arbitration hearing pending the Applicant's attendance at a follow-up insurer's psychiatric examination.

The Applicant had submitted new medical information regarding his psychological state 19 months after the Insurer's initial psychiatric assessment.

The Arbitrator found that the Insurer's request for a follow-up in-person assessment was reasonable and necessary to address the new information and determine catastrophic impairment.

The Arbitrator held that proceeding without the assessment would be procedurally unfair to the Insurer.

The motion was granted and the hearing was stayed.

The insurer brought a motion to dismiss the applicant's application for arbitration for statutory accident benefits as frivolous under Rule 68 of the Dispute Resolution Practice Code.

The insurer had already paid attendant care benefits up to the non-catastrophic policy limit of $36,000.

The applicant sought to add the issue of catastrophic impairment, but the arbitrator found the applications for catastrophic determination were not submitted before the FSCO cut-off date to add issues.

The arbitrator dismissed the application for arbitration, finding no further attendant care benefits were payable and no basis for a special award.

No costs were awarded.

The defendant brought a summary judgment motion arising from a rear-end motor vehicle collision on the Don Valley Parkway.

The court considered whether the plaintiff could rebut the presumption of negligence that applies where a driver rear-ends another vehicle.

After reviewing affidavit, documentary, and transcript evidence, the court concluded the plaintiff had not rebutted the presumption and had failed to demonstrate any genuine issue requiring a trial.

The evidence established the plaintiff was following too closely and was inattentive to surrounding traffic.

Summary judgment was granted dismissing the plaintiff’s claim.