Anu Malhotra

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied her non-earner benefits for a specific period due to her failure to submit a completed disability certificate (OCF-3) under s. 36(3) of the Schedule.

The applicant argued that the Tribunal erred in its strict interpretation of s. 36(3), asserting that the provision should not apply to an incapable applicant, and that the Tribunal failed to properly consider the Human Rights Code and the Charter.

The Vice-Chair dismissed the reconsideration request, finding that the applicant was attempting to re-litigate arguments made at the initial hearing and had failed to establish any error of law or fact under Rule 18.2(b).

The applicant was injured in a bicycle-automobile collision and suffered a traumatic brain injury.

She applied for a non-earner benefit but the insurer denied payment for the period before she submitted her disability certificate (OCF-3), relying on s. 36(3) of the Statutory Accident Benefits Schedule.

The applicant argued that s. 36(3) should be interpreted to exempt incapable applicants, or alternatively, that it violates the Charter and the Human Rights Code.

The Tribunal rejected the applicant's interpretation, finding the language of s. 36(3) clear and mandatory.

The Tribunal also found the applicant failed to establish a constitutional or Code violation.

The application was dismissed.

The applicant was seriously injured in a motor vehicle accident and sought a determination that she sustained a catastrophic impairment due to a mental or behavioural disorder.

The insurer argued that her marked impairment was a manifestation of malingering or factitious disorder, pointing to an initial period of improvement followed by deterioration.

The arbitrator reviewed extensive medical and lay evidence, finding that the applicant's current presentation of severe depression, anxiety, and pain focus was a direct result of the accident.

The arbitrator rejected the insurer's allegations of malingering, noting the lack of pre-existing conditions and the consistency of the applicant's presentation over time.

The arbitrator concluded the applicant suffered a catastrophic impairment.

The applicant sought statutory accident benefits following a motor vehicle accident, which the insurer denied on the basis that the accident was staged.

Both parties brought preliminary motions for the production of documents.

The arbitrator ordered the insurer to produce its complete adjuster's file and policy manuals, finding that the dominant purpose of an adjuster's file is the adjusting of the claim and is therefore producible, subject to specific claims of privilege.

The insurer was not required to produce legal opinions or reserves.

The applicant was ordered to produce his RBC insurance file, specific Ontario Works records, and clinical notes from one year prior to the accident.