Kathleen O’Hara

The applicant sought statutory accident benefits for the cost of renting an accessible unit following a motor vehicle accident.

The applicant owned a main residence in Thunder Bay and a vacation property in Toronto.

Due to her injuries, she rented an accessible unit in Toronto and rented out both her pre-accident properties.

The respondent argued that the rental income from both properties should be deducted from the housing benefit, resulting in no benefit payable.

The Tribunal found that only the rental income from the pre-accident main residence should be deducted, as the Schedule does not contemplate deducting income from a vacation property.

The applicant was awarded the housing benefit less the main residence rental income, plus interest.

Claims for painting expenses and an award were dismissed.

The applicant sought judicial review and appeal of a Licence Appeal Tribunal decision denying his claim for attendant care benefits.

The LAT found that the applicant failed to prove his family members sustained an economic loss in providing care, as required by s. 3(7)(e) of the Statutory Accident Benefits Schedule.

The applicant conceded the LAT correctly interpreted the provision but argued the requirement conflicted with the consumer protection mandate of the legislation and produced an absurd result.

The Divisional Court dismissed the application, holding that there was no ambiguity in the legislation and that rewriting the statute to achieve a perceived equitable result was not a justiciable issue.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming his psychological impairments and chronic pain warranted removal from the Minor Injury Guideline (MIG).

The respondent denied the benefits, arguing the injuries were predominantly minor soft tissue injuries.

The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from a psychological impairment or chronic pain with functional impairment that would remove him from the MIG.

The Tribunal preferred the respondent's medical assessments, noting the applicant had returned to full-time work and had not reported psychological symptoms to his treating physicians.

The application was dismissed, and the disputed treatment plans were found not payable as they exceeded the $3,500 MIG limit.

The applicant sought various medical and rehabilitation benefits, attendant care benefits, an award, and interest following a 2018 motor vehicle accident.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline and that pre-existing injuries from a 2016 accident were the primary cause of his ongoing complaints.

The Tribunal found that the applicant failed to establish that the proposed treatment plans were reasonable and necessary, noting a lack of objective medical evidence and failure to submit a required Form 1 for attendant care benefits.

The application was dismissed in its entirety.

The appellant insurer appealed a Licence Appeal Tribunal decision regarding the calculation of Income Replacement Benefits (IRBs) for a self-employed lawyer injured in a motor vehicle accident.

The Divisional Court found that the LAT adjudicator erred in law by applying section 4(2)3 of the Statutory Accident Benefits Schedule, which applies to employed persons, rather than section 4(3), which applies to self-employed persons.

The appeal was granted, the LAT decision was set aside, and the matter was remitted for a fresh hearing.

The applicant sought statutory accident benefits following a motor vehicle accident.

At the scheduled hearing, the applicant's representative advised that the parties had settled the matter on a full and final basis.

The Tribunal closed its file.

The applicant sought statutory accident benefits following a motor vehicle accident, including attendant care benefits, income replacement benefits (IRBs), and a treatment plan for chiropractic and physiotherapy services.

The Licence Appeal Tribunal dismissed the claim for attendant care benefits because the applicant failed to prove the expenses were incurred and failed to comply with the insurer's requests for information under s. 33 of the Schedule.

The Tribunal found the applicant was entitled to IRBs for a closed period, but after deducting post-accident employment income (including Employment Insurance benefits), the payable amount was reduced to zero.

The claim for the treatment plan was dismissed as the applicant failed to establish it was reasonable and necessary, given a 19-month gap in treatment and lack of corroborating medical evidence.

The applicant was injured in a motor vehicle accident and sought a medical benefit of $10,204.92 for a chronic pain treatment plan.

The respondent denied the benefit, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

In a prior hearing, the Tribunal determined the applicant's injuries were predominantly minor.

The respondent argued the current application was barred by res judicata.

The Tribunal found that the characterization of the applicant's injuries was decided in the first hearing and that new evidence submitted by the applicant did not conclusively impeach those findings.

The applicant also failed to prove the respondent breached statutory notice requirements under section 38 of the Schedule.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied a treatment plan for physiotherapy, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant applied to the Licence Appeal Tribunal, claiming her injuries warranted removal from the MIG due to chronic pain and psychological impairments.

The Tribunal found the applicant failed to provide sufficient medical evidence to support removal from the MIG, noting her physical injuries were soft-tissue in nature and her psychological symptoms resolved shortly after the accident.

The application was dismissed, and claims for interest and a section 10 award were denied.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits, which the respondent insurer denied on the basis that her injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that pre-existing conditions, chronic pain, and psychological impairments warranted removal from the MIG.

The Tribunal found that the applicant's physical injuries were uncomplicated soft-tissue injuries and that she failed to provide compelling evidence that any pre-existing condition prevented her recovery within the MIG.

Furthermore, the Tribunal preferred the respondent's medical evidence regarding the lack of a psychological impairment, noting inconsistencies in the applicant's expert reports.

The application was dismissed, and the disputed treatment plans were found not to be reasonable and necessary.

The respondent insurer brought a motion to dismiss the applicant's claim for statutory accident benefits due to her failure to attend two scheduled insurer medical examinations under section 44 of the Schedule.

The applicant claimed scheduling conflicts and the need for an interpreter, but the Tribunal found these explanations lacked credibility and were unsupported by the evidence.

The Tribunal declined to exercise its discretion to allow the application to proceed and dismissed the application pursuant to section 55 of the Schedule.

The applicant sought statutory accident benefits following a motor vehicle accident.

The matter was scheduled for a five-day in-person hearing, but the applicant failed to appear and his counsel withdrew.

The hearing was adjourned to a peremptory date for the applicant to address his entitlement to income replacement benefits.

The applicant again failed to appear or respond to communications from the respondent and the Tribunal.

As the applicant failed to lead any evidence to prove his entitlement to the benefits sought, the application was dismissed in its entirety.

The applicant insurer sought repayment of $7,600 in income replacement benefits (IRBs) paid to the respondent, alleging she wilfully misrepresented her employment status at the time of the accident.

The respondent claimed she was employed as a cleaner, but her testimony was contradicted by the alleged employer's Human Resources Director and documentary evidence, including bank statements and tax records.

The Tribunal found the respondent was not a credible witness and concluded she was unemployed at the time of the accident.

The Tribunal ordered the respondent to repay the $7,600 in IRBs plus interest due to wilful misrepresentation.

The respondent insurer requested a reconsideration of a Tribunal order dismissing its motion for the production of the applicant's pre-accident bank records.

The insurer sought the records to investigate a potential material misrepresentation regarding the applicant's residence, which would affect entitlement to income replacement benefits.

The Vice Chair granted the reconsideration, finding that the Tribunal made significant errors of fact and law by concluding the records were only relevant to quantum and by accepting a lawyer's letter as sufficient evidence of 'best efforts' to obtain the closed account records.

The applicant was ordered to make written inquiries to the bank to obtain the records.

The applicant brought a motion seeking production of unredacted adjuster log notes and an order declaring third-party property damage and bodily injury files inadmissible.

The respondent had denied benefits on the basis that no accident occurred and the applicant made material misrepresentations.

The Tribunal dismissed the motion for unredacted notes but ordered the respondent to produce redacted log notes, including those of the third parties, with detailed explanations for each redaction.

The Tribunal found the notes were presumptively relevant to understanding the basis for the denial of benefits, and the respondent could not use privilege as a shield to prevent disclosing the reasons for denial.

The applicant sought statutory accident benefits following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the applicant's claims for a chiropractic assessment incurred before the treatment plan was filed, and for the unapproved portions of a nutritional counselling treatment plan, finding the applicant failed to prove they were reasonable and necessary.

The Tribunal ordered the insurer to pay for various approved expenses, including an iPad and furniture, subject to the applicant providing invoices, and found no interest was owing as there were no overdue payments.

The applicant was injured in a motor vehicle accident and sought payment for two orthopaedic assessments under the Statutory Accident Benefits Schedule.

The insurer denied the treatment plans.

The Licence Appeal Tribunal found that the applicant failed to prove the assessments were reasonable and necessary, noting the absence of the actual treatment plans in evidence and preferring the insurer's medical evidence that the applicant suffered only soft tissue injuries.

The appeal was dismissed.

The insurer, having successfully defended the applicant's claim for accident benefits at arbitration, sought $22,820.05 in expenses.

The arbitrator considered the criteria under Rule 75.2 of the Dispute Resolution Practice Code and the principle of fairness, noting the Schedule is consumer protection legislation.

Given the applicant's limited income from Canada Pension Plan disability benefits and the uncomplicated nature of the case, the arbitrator fixed the insurer's expenses at $2,500.00 inclusive of fees, disbursements, and HST.

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

Prior to a scheduled case conference, the applicant withdrew the appeal application.

The respondent subsequently brought a motion for costs, alleging the applicant acted frivolously, vexatiously, and in bad faith by misrepresenting his employment status.

The adjudicator dismissed the motion, finding that the respondent's evidence, which relied entirely on hearsay from an unidentified confidential source, was unreliable and insufficient to establish bad faith or unreasonable conduct under Rule 19.1.

The defendant brought a summary judgment motion arising from a rear-end motor vehicle collision on the Don Valley Parkway.

The court considered whether the plaintiff could rebut the presumption of negligence that applies where a driver rear-ends another vehicle.

After reviewing affidavit, documentary, and transcript evidence, the court concluded the plaintiff had not rebutted the presumption and had failed to demonstrate any genuine issue requiring a trial.

The evidence established the plaintiff was following too closely and was inattentive to surrounding traffic.

Summary judgment was granted dismissing the plaintiff’s claim.