Leanne Zawadzki

The applicant sought statutory accident benefits following a motor vehicle accident, arguing her psychological and physical injuries warranted removal from the Minor Injury Guideline (MIG).

The Tribunal found the applicant's injuries were predominantly minor, preferring the respondent's psychological assessment over the applicant's because it better aligned with contemporaneous medical records.

While most of the respondent's denial letters complied with s. 38(8) of the Schedule, one denial for a psychological assessment was found non-compliant for failing to provide specific medical reasons.

Consequently, the respondent was ordered to pay expenses incurred under that plan until the defective notice was cured.

The applicant's claim for an award under s. 10 of Reg. 664 was dismissed, as the non-compliant notice was deemed a wrong adjusting decision rather than unreasonable conduct.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment due to mental and behavioural disorders.

The Tribunal found the applicant catastrophically impaired under Criterion 8, as her psychological impairments significantly impeded useful functioning in concentration, persistence, and pace.

The Tribunal awarded post-104 income replacement benefits and partial attendant care benefits, but denied the disputed treatment plans as the applicant failed to establish they were reasonable and necessary.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, claiming she sustained a catastrophic impairment due to a mental or behavioural disorder.

The Tribunal applied the Pastore test and found that the applicant suffered from class 4 (marked) impairments in activities of daily living, social functioning, and adaptation, meeting the threshold for catastrophic impairment.

The Tribunal also awarded $4,077.72 in attendant care benefits with interest, but dismissed the claim for a special award under s. 10 of Regulation 664, finding the insurer did not unreasonably withhold payments.

The applicant sought an award under section 10 of O. Reg. 664, alleging the respondent unreasonably delayed or withheld payment of a benefit by failing to provide a response to a psychological treatment plan.

The respondent admitted to making administrative errors in sending the approval to the wrong fax number and email address.

The Tribunal dismissed the application, finding that while the respondent made errors, there was no evidence that payment of a benefit was unreasonably withheld or delayed, as the applicant had not incurred any of the goods or services listed in the treatment plan.

The applicant requested a reconsideration of a preliminary issue decision which found her application for an income replacement benefit premature due to her failure to submit a Disability Certificate (OCF-3).

The applicant argued that the adjudicator made material errors of fact and law regarding the delivery of the OCF-3 to the insurer.

The Tribunal dismissed the request, finding that the applicant was merely attempting to relitigate the matter and reweigh the evidence, and failed to identify any material error that would have changed the outcome.

The applicant requested a reconsideration of a decision that found she was not entitled to statutory accident benefits because she was not living in Ontario at the time of the accident and was not insured under an Ontario motor vehicle policy.

The applicant argued the Tribunal acted outside its jurisdiction and made errors of law and fact.

The Tribunal dismissed the reconsideration request, finding no errors of law or fact and concluding that the applicant was attempting to reargue her case.

The applicant was involved in a motor vehicle accident in Alberta while driving a vehicle registered and insured in Alberta.

She subsequently moved to Ontario and sought statutory accident benefits under the Ontario Schedule, arguing she could elect Ontario benefits because the insurer has offices in both provinces.

The Licence Appeal Tribunal held that the applicant was not an 'insured person' under section 3(1) of the Schedule, as she was not a resident of Ontario at the time of the accident and the vehicle was not operated in Ontario.

The application was dismissed.

The respondent insurer brought a preliminary issue motion to stay the applicant's claim for an income replacement benefit (IRB) on the basis that it was premature.

The insurer argued the applicant failed to submit a Disability Certificate (OCF-3) prior to applying to the Licence Appeal Tribunal.

The applicant contended the OCF-3 was faxed to the insurer in December 2017 or included in a bundle of clinical notes in November 2019.

The Tribunal found that the applicant did not properly submit the OCF-3 until May 2020, after the Tribunal application was commenced.

As there was no valid application for the benefit and no denial at the time of filing, there was no dispute over entitlement.

The claim for an IRB was dismissed as premature.

In an automobile insurance priority dispute, the appellant insurer sought production of communications between two other insurers regarding a section 10 notice.

The appellant argued the notice was part of an inappropriate scheme to circumvent the 90-day notice requirement.

The arbitrator dismissed the motion, finding the communications irrelevant as the initial notice was made in good faith.

On appeal, the Superior Court of Justice found no palpable and overriding error in the arbitrator's decision and dismissed the appeal.

The applicant was injured in a motor vehicle accident and sought approval for psychological and physiatry assessments.

The insurer denied the treatment plans on the basis that they were not reasonable and necessary, noting that it had already approved nine other assessments related to a catastrophic impairment determination.

The Tribunal found that the requested assessments were duplicative and not reasonable and necessary given the comprehensive slate of assessments already approved.

The claims for the costs of examination and interest were dismissed.

The insurer's request for costs was also dismissed.

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

After his death, his Estate commenced arbitration proceedings for denied treatment plans.

The insurer brought a motion to dismiss the application as frivolous, vexatious, and an abuse of process, arguing that the treatments could not be provided to a deceased person and that some claims were statute-barred.

The Arbitrator agreed, finding that the obligation to pay for medical and rehabilitation benefits ends with the insured person's death, as the treatments cannot reduce or eliminate impairments.

The application was dismissed.

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

The insurer brought a motion to preclude the applicant from proceeding to arbitration due to a failure to attend insurer's examinations or produce documents.

The parties settled all issues in the motion except for interim expenses.

The arbitrator deferred the decision on interim expenses to the hearing arbitrator, noting that expense awards for interlocutory proceedings should be reserved for exceptional cases and the hearing arbitrator is best placed to consider any misconduct in the context of the entire proceedings.

The applicant applied for statutory accident benefits following a motor vehicle accident.

After the applicant's representatives were permitted to withdraw due to a breakdown in the solicitor-client relationship, the applicant failed to attend a pre-hearing discussion and the scheduled arbitration hearing.

The arbitrator proceeded in the applicant's absence.

As the applicant presented no evidence to establish entitlement to the claimed benefits, the claims were dismissed.