10 total
Applicant held to Minor Injury Guideline; 5% award granted for insurer's unreasonable delay in payment.
The applicant sought statutory accident benefits following a motor vehicle accident, arguing his injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain.
The Tribunal found the applicant's medical evidence, including a chronic pain assessment, to be internally inconsistent and of limited persuasive value.
Consequently, the applicant's injuries were deemed predominantly minor and subject to the MIG limit, rendering the disputed treatment plans moot.
However, the Tribunal granted a 5% award against the respondent for unreasonably delaying payment of a previously approved and invoiced treatment plan.
Application for accident benefits dismissed due to unexcused two-year delay in submitting OCF-1 form.
The applicant was involved in a motor vehicle accident and sought statutory accident benefits.
The respondent denied benefits because the applicant failed to submit her Application for Accident Benefits (OCF-1) within 30 days of receiving the forms, as required by s. 32(5) of the Schedule.
The applicant argued she delayed submitting the form on the advice of her doctor to defer treatment.
The Tribunal found this was not a reasonable explanation for the delay and that the respondent suffered prejudice due to the nearly two-year delay.
Consequently, the application was dismissed as the applicant was precluded from applying to the Tribunal under s. 55(1)1 of the Schedule.
Application for income replacement benefits dismissed due to failure to prove inability and causation.
The applicant sought income replacement benefits (IRBs) following a motor vehicle accident while she was on maternity leave.
The Tribunal found that the applicant failed to prove on a balance of probabilities that she suffered a substantial inability to perform the essential tasks of her pre-accident employment within 104 weeks of the accident.
Furthermore, the Tribunal drew an adverse inference due to a gap in medical evidence and the occurrence of a second motor vehicle accident, concluding the applicant failed to establish causation.
The claim for IRBs beyond 104 weeks was also dismissed due to insufficient evidence regarding the applicant's education, training, and experience.
The application was dismissed.
Application for accident benefits dismissed; applicant's injuries fell within the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident, arguing his injuries fell outside the Minor Injury Guideline (MIG) due to chronic pain.
The applicant also argued the insurer was barred from relying on the MIG due to alleged non-compliance with the 10-day notice requirement under s. 38(8) of the Schedule.
The Tribunal found the insurer had complied with the notice requirements.
Furthermore, relying on medical assessments from both parties' experts which showed largely normal findings, the Tribunal concluded the applicant did not meet the AMA Guides criteria for chronic pain.
The application was dismissed as the injuries were predominantly minor and the $3,500 limit had been exhausted.
Partial summary judgment granted dismissing unsafe parking lot claim; unsafe shopping cart claim deferred for further evidence.
The plaintiff was injured when she fell while chasing a rolling shopping cart in a sloped parking garage at a shopping mall.
The defendant mall owners moved for summary judgment.
The court dismissed the plaintiff's 'unsafe parking lot' theory, as the defendants provided uncontradicted expert evidence that the ramp complied with safety standards.
However, the court deferred judgment on the 'unsafe shopping cart' theory, giving the plaintiff an opportunity to amend her pleadings, demand a defence from the retailer that provided the cart, and obtain expert evidence.
Appeal dismissed; plaintiff failed to justify setting aside administrative dismissal for delay in serving claim.
The appellant appealed a Master's order dismissing a motion to set aside a Registrar's order that dismissed the action as abandoned.
The underlying claim arose from a motor vehicle accident, but the appellant failed to serve the statement of claim or take reasonable steps to locate the respondent before the action was administratively dismissed.
The Divisional Court found no palpable and overriding errors in the Master's factual findings and held that the Master correctly applied the Reid factors, noting the lack of explanation for the delay, failure to move promptly, and prejudice to the respondent due to the expired limitation period.
The appeal was dismissed.
Administrative dismissal set aside and leave granted to add uninsured motorist insurer.
The plaintiff brought a motion under Rule 37.14 of the Rules of Civil Procedure to set aside an administrative dismissal order for abandonment and sought leave to amend the statement of claim to add the plaintiff’s insurer as a defendant under uninsured motorist coverage.
The court applied the factors governing relief from administrative dismissal, including the explanation for delay, inadvertence, delay in bringing the motion, and prejudice to the defendants.
Although the motion to set aside was not brought promptly, the court found the delay was not inordinate, the missed deadline resulted from inadvertence, and no actual prejudice was demonstrated.
The court emphasized the preference for resolving disputes on their merits.
The dismissal order was set aside and the plaintiff was granted leave to amend the claim to add the insurer.
Accident benefits claim dismissed; expert evidence proved the alleged collision never occurred, constituting willful misrepresentation.
The applicant sought statutory accident benefits following an alleged motor vehicle collision where he claimed to be a passenger in a BMW struck by a Nissan.
The insurer denied the claim, arguing the accident did not occur.
At a preliminary issue hearing, the insurer presented uncontroverted expert evidence from a collision reconstructionist demonstrating that the physical damage to the vehicles was entirely inconsistent with a collision between them.
The arbitrator accepted the expert's findings, concluded the applicant was not involved in an accident as defined by the Schedule, and found that the applicant had wilfully misrepresented material facts in his application for benefits.
Arbitration application dismissed without costs after applicant failed to appear or communicate with counsel.
The applicant applied for arbitration regarding statutory accident benefits following a motor vehicle accident.
The applicant failed to appear at the pre-hearing and the scheduled arbitration hearing, and had not communicated with his counsel or the Commission for months.
Counsel's request to be removed from the record was granted.
The insurer's request to dismiss the arbitration on a without costs basis was granted due to the applicant's failure to appear and provide instructions.
Leave granted to appeal order adding defendants after limitation period expired.
The moving parties sought leave to appeal an interlocutory order permitting the plaintiff to amend a statement of claim to add them as defendants after the expiration of the limitation period.
The court considered whether there was good reason to doubt the correctness of the motion judge’s decision and whether the issue raised matters of sufficient importance under Rule 62.02(4) of the Rules of Civil Procedure.
The court found that the plaintiff provided no evidence demonstrating reasonable diligence in identifying the proposed defendants prior to the expiry of the limitation period and no evidence of special circumstances justifying the amendment.
As a result, there was reason to doubt the correctness of the underlying order and the issue raised broader questions concerning limitation periods and amendments to pleadings.
Leave to appeal to the Divisional Court was granted.