Jasmine Daya

The applicant, who was catastrophically injured in a motor vehicle accident, sought payment of legal fees incurred in obtaining a guardianship order as a rehabilitative benefit under the Statutory Accident Benefits Schedule.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to submit a treatment and assessment plan in advance of incurring the expense, as required by section 38(2) of the Schedule.

The Tribunal also dismissed the claims for interest, costs, and a special award.

The applicant was injured in a motor vehicle accident and sought Income Replacement Benefits (IRBs) and medical benefits for chiropractic services.

The insurer terminated IRBs and denied further treatment on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and he was able to return to work.

The Tribunal found the applicant's self-reporting to be unreliable, noting he had returned to work multiple times without disclosing it to the insurer or medical assessors.

Relying on independent medical examinations and surveillance evidence, the Tribunal concluded the applicant did not suffer a substantial inability to perform the essential tasks of his employment and his injuries were treatable within the MIG.

The application was dismissed.

The applicant sought reconsideration of a Licence Appeal Tribunal decision that denied her claim for ongoing attendant care benefits.

The applicant argued that the Tribunal erred in finding it lacked equitable jurisdiction to apply estoppel by convention, which would have prevented the insurer from terminating benefits it had mistakenly paid for several months.

The Executive Chair dismissed the request, holding that the Tribunal must resolve disputes in accordance with the Statutory Accident Benefits Schedule and cannot use equity to override the statutory requirement that expenses be 'incurred.' Furthermore, the test for estoppel by convention was not met, as the parties did not share a mutual assumption and the applicant suffered no detriment.

The appellant insurer appealed an arbitrator's preliminary decision finding that the issues in dispute had not been previously settled.

The insurer argued that an agreement reached between counsel constituted a binding settlement, despite the absence of a signed Settlement Disclosure Notice or release, because it did not finally dispose of all claims.

The Director's Delegate dismissed the appeal, holding that the Settlement Regulation applies to agreements that finally dispose of one or more benefits, and that the required disclosure notice and cooling-off period are mandatory consumer protection measures.

As the respondent was a person under disability and the mandatory settlement procedures were not followed, no binding settlement was reached.

The applicant sought statutory accident benefits for attendant care provided by her husband, a medical doctor, following a motor vehicle accident.

The insurer denied the benefits on the basis that the expenses were not 'incurred' under section 3(7)(e) of the Schedule.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the services were provided as claimed, there was no legal obligation to pay, and the husband did not sustain an economic loss or provide the services in the ordinary course of his profession.

The Tribunal also denied the cost of an examination and held it lacked jurisdiction to grant equitable relief such as estoppel.

The applicant, who was in a coma following a motor vehicle accident, applied for statutory accident benefits through his litigation guardian.

The insurer argued that the issues in dispute had been previously settled by the applicant's former legal counsel.

The arbitrator found that no binding settlement had been reached, as the applicant was a person under a disability and no settlement documents had been signed or approved by the court as required by Rule 7.08 of the Rules of Civil Procedure.

Following a jury verdict awarding damages for personal injury arising from a motor vehicle accident, the court addressed entitlement to costs in light of competing Rule 49 settlement offers.

The jury awarded $60,000 in total damages, including $15,000 for general damages and $45,000 for future loss of income or competitive advantage.

The court considered whether prejudgment interest should be notionally applied to the general damages award when comparing the verdict to the defendant’s settlement offer for Rule 49 purposes, particularly given the statutory deduction under the Insurance Act.

The court held that statutory deductions are ignored when determining entitlement to costs and that prejudgment interest should be notionally added to the general damages.

With that calculation, the plaintiff obtained a judgment slightly more favourable than the defendant’s offer and was therefore presumptively entitled to costs.