Joelle Briggs-Sears

The respondent insurer sought reconsideration of a Tribunal decision that found the applicant was entitled to income replacement benefits during a period of suspension for non-attendance at an insurer's examination.

The applicant had attended the examination but requested his wife be present, which the examiner refused.

While the applicant sought advice from his representative, the examiner left the facility.

The adjudicator found that although the original decision lacked sufficient reasons regarding the specific events, the ultimate finding was correct.

The applicant did not refuse to submit to the examination requests, and even if he did, he had a reasonable excuse.

The request for reconsideration was denied.

The applicant sought reconsideration of a Licence Appeal Tribunal decision that found her injuries fell within the Minor Injury Guideline (MIG) and denied her treatment plans.

The adjudicator granted the reconsideration, finding multiple breaches of procedural fairness in the original decision.

Specifically, the original adjudicator failed to address costs, made a finding on the MIG when it was not an issue in dispute, misapplied the causation test by failing to analyze new post-accident injuries, and improperly relied on a previous Financial Services Commission of Ontario decision as evidence rather than case law.

The matter was ordered to be re-heard before a different adjudicator.

Following a jury trial where the plaintiff was awarded damages for injuries sustained at a speedway, the parties could not agree on the quantum of costs.

The plaintiff sought partial indemnity costs of $269,371, while the defendant proposed $150,000.

The court considered factors including the principle of proportionality, the defendant's unreasonable refusal to mediate, and the plaintiff's extensive use of jury focus groups.

The court adjusted the plaintiff's claimed hourly rates and time spent, but penalized the defendant for refusing to mediate, ultimately fixing costs at $210,000 plus taxes.

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident.

The respondent insurer suspended the IRBs for a seven-week period, alleging the applicant failed to comply with an insurer's examination (IE) when he objected to the exclusion of his wife and the presence of a transcriptionist.

The Tribunal found that the applicant had a reasonable explanation for his non-compliance, given his psychological difficulties, his expectation based on past IEs that his wife could attend, and his good-faith efforts to resolve the issue at the time.

The Tribunal ordered the respondent to pay the withheld IRBs with interest, but dismissed the applicant's claim for a special award, finding the insurer's actions were not unreasonable.

The applicant was injured in a motorcycle accident and received income replacement benefits.

The insurer suspended benefits after the applicant refused to attend an insurer's examination, arguing the insurer failed to provide valid 'medical and any other reasons' as required by section 44 of the Statutory Accident Benefits Schedule.

The Tribunal found that the insurer's stated reasons—to determine timelines for recovery and future prognosis—were valid, given the applicant's ongoing treatment and potential need for surgery.

Consequently, the applicant was precluded from receiving benefits during the period of non-compliance, and his claim for a special award was dismissed.