Kerry L. Figliomeni

The applicant was sitting in his parked vehicle when he was assaulted by armed assailants attempting to steal his car.

While trying to escape, the applicant put the vehicle in reverse with his leg outside the door, colliding with a dumpster and resulting in the amputation of his leg.

The respondent denied statutory accident benefits on the basis that the incident was an assault, not an accident.

The Tribunal applied the two-part purpose and causation test, finding that reversing the vehicle was an ordinary use of an automobile and was the dominant feature that directly caused the applicant's leg injury.

The Tribunal concluded the incident met the definition of an 'accident' under section 3(1) of the Schedule.

The applicant sought statutory accident benefits for medical treatments and examinations following a 2011 motor vehicle accident.

The respondent denied the benefits, arguing that the applicant's impairments were related to pre-existing degenerative conditions and a subsequent 2017 accident, rather than the 2011 accident.

The Tribunal applied the 'but for' test for causation and found that the applicant failed to prove the 2011 accident was a necessary cause of his impairments.

The Tribunal relied on the lack of contemporaneous medical evidence of injury, the applicant's extensive pre-existing health history, and surveillance evidence that contradicted the claimed impairments.

The application was dismissed.

The applicant was injured in a 2015 motor vehicle accident and sought statutory accident benefits.

The insurer denied medical benefits, placing her in the Minor Injury Guideline (MIG), and denied a non-earner benefit.

The Tribunal found that the accident exacerbated the applicant's pre-existing conditions and caused chronic pain, removing her from the MIG.

The Tribunal ordered the insurer to pay for a psychological assessment with interest, finding it reasonable and necessary.

However, the claims for an in-home attendant care assessment and a non-earner benefit were dismissed, as the applicant failed to prove a complete inability to carry on a normal life.

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

The respondent raised a preliminary issue that the claims were statute-barred under the two-year limitation period.

Prior to the written hearing, the applicant withdrew the preliminary issues in dispute.

The respondent subsequently sought costs, arguing the application was a duplication of previous proceedings at the Financial Services Commission of Ontario and was frivolous, vexatious, and in bad faith.

The Tribunal found that the previous proceedings did not result in a hearing on the merits or a binding settlement, and the applicant's withdrawal of the issues did not constitute unreasonable conduct.

The respondent's request for costs was dismissed.

The applicant was injured in a 2015 motor vehicle accident and sought accident benefits, which the respondent insurer denied on the basis that her injuries fell within the Minor Injury Guideline (MIG).

The applicant had significant pre-existing injuries from prior accidents.

The Tribunal found that the subject accident exacerbated her pre-existing conditions and caused chronic pain, removing her from the MIG.

The Tribunal ordered the respondent to pay for a psychological assessment, finding it reasonable and necessary, along with interest.

However, the Tribunal dismissed the claims for an In-Home Attendant Care assessment and a non-earner benefit, as the applicant failed to prove a complete inability to carry on a normal life.

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

During her in-person hearing, she suffered an anxiety attack and was unable to complete her cross-examination.

The respondent sought to complete the cross-examination, while the applicant argued her affidavit should be accepted without further questioning.

The Tribunal ordered the applicant to complete a limited, two-hour cross-examination via teleconference, with mandatory breaks, to balance the respondent's right to a fair hearing with the applicant's medical needs.

The applicant sought reconsideration of a Licence Appeal Tribunal decision that denied funding for catastrophic impairment assessments.

The applicant argued the Tribunal applied the wrong legal test and improperly weighed evidence.

The Vice-Chair dismissed the request, finding that the applicant improperly attempted to introduce new evidence and that the original adjudicator correctly applied the test of whether further investigation was reasonable and necessary.

The request for reconsideration was denied.