Heather L. Kawaguchi

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) from the respondent insurer.

The insurer terminated the IRBs, and the applicant appealed to the Licence Appeal Tribunal seeking IRBs for a disputed period of approximately three weeks before she returned to work.

The Tribunal found that the applicant failed to provide contemporaneous medical evidence demonstrating a substantial inability to perform the essential tasks of her pre-accident employment as a hairdresser.

Relying on the respondent's multidisciplinary independent medical examination, the Tribunal dismissed the claim for IRBs, interest, and costs.

The applicant sought various medical assessments following a 2010 motor vehicle accident.

The respondent insurer denied the assessments.

The Licence Appeal Tribunal found that the chronic pain and physiatry assessments were reasonably required due to consistent medical evidence of ongoing ankle pain and the risk of progressive osteoarthritis.

However, the Tribunal dismissed the claims for work site, psychological, attendant care, and function and impairment assessments, finding insufficient evidence to support their necessity, particularly given the applicant's independence in self-care and lack of documented psychological symptoms prior to 2014.

Interest was awarded on the overdue payments for the approved assessments.

The defendant brought a motion for summary judgment seeking dismissal of a motor vehicle negligence action as statute-barred under the Limitations Act, 2002.

The central issue was when the plaintiff discovered or ought to have discovered that her injuries met the statutory threshold under s. 266(1) of the Insurance Act, which would permit recovery of damages for bodily injury.

The court reviewed extensive and conflicting medical evidence regarding the seriousness and permanence of the plaintiff’s injuries and whether objective evidence existed before April 22, 2007 establishing a threshold claim exceeding the statutory deductible.

Applying the framework in Hryniak v. Mauldin, the court concluded that determining discoverability would require weighing complex medical evidence and credibility issues inappropriate for summary judgment.

A genuine issue requiring trial existed regarding when the plaintiff’s injuries became objectively discoverable as meeting the threshold.

The insured was injured in a motor vehicle accident and applied for a catastrophic impairment determination.

The insurer denied the application based on its medical examinations.

The insured submitted a rebuttal report beyond the 80-day time limit and sought payment for its cost.

The arbitrator found the insured had a reasonable explanation for the delay and ordered the insurer to pay the report's cost.

On appeal, the Director's Delegate upheld the finding of a reasonable explanation but found the arbitrator erred in law by reversing the onus of proof regarding the reasonableness of the report's cost.

The issue of the report's cost was remitted for re-determination.

The insurer appealed an arbitrator's decision ordering it to pay the cost of a late-filed catastrophic impairment rebuttal report plus interest.

The insured sought an extension of time to file a cross-appeal, which the Director's Delegate granted, finding minimal prejudice and that it would produce the most just and quickest resolution.

The insurer also sought a stay of the arbitrator's order pending the appeal.

The Delegate granted a partial stay, staying the interest component of the order but requiring the insurer to pay the principal sum of $16,896.64 for the report, noting the hardship considerations and an undertaking from the assessment clinic to repay the funds if the appeal is successful.

The appellant appealed an arbitrator's expense award in his personal capacity.

The appeal was ultimately dismissed as being without substance.

The parties could not agree on the legal expenses of the appeal proceeding.

The Director's Delegate found that the respondent was entirely successful on the ultimate outcome and entitled to its reasonable legal expenses.

The Delegate ordered the appellant to pay the respondent $3,075.11 in legal expenses, inclusive of GST.

The appellant, a lawyer, appealed an arbitrator's orders holding him jointly and severally liable with his client for legal expenses thrown away due to the client's repeated failure to attend pre-hearing discussions.

The arbitrator found the appellant breached an undertaking to ensure the client's attendance and exhibited a cavalier attitude constituting an abuse of process.

The Director's Delegate dismissed the appeal, finding no error in the arbitrator's application of section 282(11.2) of the Insurance Act to award costs personally against the representative for unreasonable default of professional responsibilities.

The appellant, a legal representative, appealed an arbitrator's order holding him personally liable for the insurer's legal expenses due to his client's non-attendance at pre-hearings.

The representative sought to withdraw as counsel of record due to a conflict of interest and a breakdown in the solicitor-client relationship.

The Director's Delegate permitted the withdrawal.

On the issue of standing, the Delegate held that a representative against whom an expense order is made has a substantial and direct interest in the outcome, entitling them to party status under section 5 of the Statutory Powers Procedure Act for the purpose of appealing the expense order.