James R. Adams

The respondent was injured in a rear-end motor vehicle accident and claimed non-earner benefits from his insurer.

The trial judge awarded the benefits, finding the respondent suffered a partial inability to carry on a normal life that developed into chronic pain.

The Court of Appeal allowed the insurer's appeal, holding that the trial judge applied the wrong legal test.

Under the Statutory Accident Benefits Schedule, an insured must demonstrate a complete inability to carry on a normal life within 104 weeks of the accident, which requires showing an impairment that continuously prevents them from engaging in substantially all pre-accident activities.

The respondent failed to provide sufficient evidence of his pre-accident activities to satisfy this threshold.

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

The insurer argued that the applicant was precluded from coverage under section 1.8.4 of the Ontario Automobile Policy (OAP 1), which excludes coverage for persons who sell or repair automobiles as part of a business while involved in conducting that business.

The applicant and his brother had leased dealer plates to buy and sell cars for profit, but had only sold one car prior to the accident.

The arbitrator found that the enterprise was not sufficiently developed to be considered a business at the time of the accident.

Furthermore, even if it were a business, the insurer failed to prove that the applicant was involved in conducting that business when the accident occurred.

The arbitrator concluded that the applicant was not precluded from coverage.

The appellant episcopal corporation appealed a finding of direct liability for sexual assaults committed by a parish priest over two decades.

The respondents cross-appealed, arguing the corporation was also vicariously liable.

The Supreme Court of Canada dismissed the appeal, confirming the corporation was directly liable because the bishop's failure to properly direct and discipline the priest constituted negligence by the corporation.

The Court also held the corporation vicariously liable, finding a sufficiently close relationship between the diocesan enterprise and the priest, and a strong connection between the employer-created risk and the wrongful acts.

The appellant husband was seriously injured in a motor vehicle accident, rendering him unable to continue providing caregiving services to his wife, who suffered from a pre-existing medical condition.

The husband elected to receive income replacement benefits rather than caregiver benefits under the Statutory Accident Benefits Schedule.

The wife brought a derivative claim under s. 61 of the Family Law Act for the cost of hiring a substitute caregiver.

The Court of Appeal held that the substitute caregiver expenses were not 'health care' expenses under the Insurance Act, meaning the defendants were not protected from liability.

Furthermore, the court held that the wife's claim was her own statutory cause of action and was not barred by her husband's election of benefits.

The appellant, a self-employed carpenter, was injured in a motor vehicle accident and received income replacement benefits (IRBs).

Shortly after returning to work, he was injured in a second accident.

The insurer accepted the claim for IRBs but refused to include the IRBs from the first accident in the calculation of his pre-accident income.

The Director's Delegate dismissed the appeal, holding that under the SABS-1996, temporary disability benefits such as IRBs are not considered income from employment and cannot be included in the calculation of pre-accident income, despite the harsh result for the appellant.

The appellant challenged a motion judge's refusal to permit amendments to plead negligence and insurer bad faith in an insurance action.

The Court of Appeal held that, to the extent the proposed negligence claim advanced an independent cause of action not governed by the policy's one-year statutory limitation period, it was subject to the six-year negligence limitation period and was sought too late absent special circumstances.

The court found no basis to interfere with the motion judge's finding that no such special circumstances existed.

The proposed bad faith amendments were also deficient because they either related to costs or failed to disclose a proper legal basis.

The appeal was dismissed with costs.

The applicant was injured in two motor vehicle accidents and received weekly income benefits.

The insurer reduced the benefits after the applicant began receiving CPP disability benefits, and later refused to restore the higher rate following court decisions holding that CPP benefits were not deductible.

The insurer argued the applicant was barred from arbitrating the issue by the two-year limitation period.

The arbitrator found that the insurer's notice of benefit reduction did not constitute a proper refusal to pay, as the applicant had already agreed to a reduction and proposed a repayment method.

Therefore, the limitation period had not commenced, and the applicant was not time-barred.

The arbitrator declined to order a special award, finding the insurer's position was based on an honestly-held error rather than bad faith, but awarded interest on overdue amounts and expenses to the applicant.

The applicant was injured in a minor rear-end motor vehicle accident and subsequently developed chronic pain and fibromyalgia.

The insurer terminated his weekly income replacement benefits after a DAC assessment concluded he could return to work.

The arbitrator found that the applicant sustained an impairment in his lower back arising from the accident, which caused a substantial inability to perform the essential tasks of his employment as an assembly line worker.

The arbitrator also found that the applicant suffered from post-traumatic fibromyalgia.

The applicant was awarded ongoing income replacement benefits, costs for a physical fitness programme, expenses for attending a Fibromyalgia Outpatient Programme, partial housekeeping expenses, interest, and arbitration expenses.

The appellant appealed an arbitrator's order denying him continued weekly income benefits following a motor vehicle accident.

The arbitrator had found the appellant's medical evidence compromised due to his failure to disclose prior accidents to his treating physicians and discrepancies between his reported limitations and surveillance footage.

The Director's Delegate dismissed the appeal, holding that the arbitrator's credibility findings and assessment of the medical evidence were supported by the record and should not be interfered with.

The appellant's request for appeal expenses was also denied as the appeal did not raise a significant issue.