8 total
Appeal from insurance priority dispute arbitration dismissed; no error in finding truck was involved in an accident.
The appellant appealed a judgment dismissing an appeal from an arbitrator's decision in an insurance priority dispute.
The appellant argued the judge erred in finding the arbitrator owed no deference to the Licence Appeal Tribunal and in concluding the truck was involved in an accident.
The Court of Appeal found no error in the reasons for judgment and dismissed the appeal, awarding costs of $15,000 to the respondent.
Appeal dismissed; late SABS claim without reasonable explanation properly barred under s. 55(1)1.
The appellant appealed a Licence Appeal Tribunal decision dismissing her claim for statutory accident benefits due to a two-year delay in notifying her insurer.
The appellant argued the Tribunal erred in law by dismissing the claim under s. 55(1)1 of the Statutory Accident Benefits Schedule, asserting that s. 32(10) provided the insurer's exclusive remedy of extra time to respond.
The Divisional Court dismissed the appeal, holding that s. 32(10) does not preclude the dismissal of a claim under s. 55(1)1 where the claimant fails to provide a reasonable explanation for the delay.
Reconsideration denied as new medical reports could have been obtained previously and contradicted surveillance evidence.
The applicant sought reconsideration of a decision denying her income replacement benefits beyond 104 weeks post-accident, relying on four new multidisciplinary reports as new evidence under Rule 18.2(d).
The Tribunal dismissed the request, finding that the reports could have been obtained prior to the release of the original decision and that the applicant made a tactical decision not to seek an adjournment.
Furthermore, the Tribunal held that the new evidence would not have affected the result, as the reports relied on self-reporting that was contradicted by surveillance evidence showing the applicant engaging in various activities.
The respondent's request for costs was also dismissed.
Attendant care benefits partially granted; 24-7 supervision denied and $2,000 cap applied to assessment.
The applicant, who was deemed catastrophically impaired following a 1999 motor vehicle accident, sought attendant care benefits and the cost of a home modification assessment.
The Tribunal found that the applicant did not have to 'incur' past attendant care benefits for them to be payable, as the 1996 Schedule applied.
The Tribunal awarded attendant care benefits for the period of October 2016 to July 2017 but dismissed the claims for other periods, finding the applicant did not require 24-7 supervision.
The Tribunal also dismissed the claim for the home modification assessment, finding the $2,000 cap under the 2010 Schedule applied.
Costs motion dismissed as respondent's late concession of catastrophic impairment was not unreasonable or in bad faith.
The applicant sought costs after the respondent conceded catastrophic impairment less than two weeks before the scheduled hearing.
The applicant argued the respondent acted unreasonably, frivolously, and in bad faith by delaying the concession and failing to produce two medical reports.
The Tribunal dismissed the motion, finding the respondent acted reasonably in relying on its medical evidence and noting the applicant's low medical/rehabilitation expenses.
The Tribunal also found no breach of disclosure orders, as the applicant could have obtained the reports directly from his own service providers.
Incident where an ATV spooked a horse, causing it to throw its rider, constitutes an 'accident' under SABS.
The respondent was injured when her horse was spooked by an oncoming ATV, causing her to be thrown and trampled in a muddy ditch.
She claimed statutory accident benefits from the appellant insurer.
The arbitrator found the incident was an 'accident' under the SABS.
The insurer appealed, arguing the horse and mud were intervening acts and the dominant feature of the injuries.
The Director's Delegate dismissed the appeal, finding the ATV was being put to an ordinary use and its operation was the direct cause and dominant feature of the incident, as spooking a horse is an ordinary risk of motoring on a rural road.
Appeal of accident benefits arbitration dismissal rejected for failing to raise a question of law.
The appellant appealed an arbitrator's decision dismissing his application for arbitration regarding statutory accident benefits on the basis that it was filed beyond the two-year limitation period.
The appellant, who was self-represented and had been incarcerated, sought multiple extensions of time to file his appeal submissions.
The Director's Delegate refused to grant further extensions and rejected the appeal under Rule 51.2(b) of the Dispute Resolution Practice Code because it did not raise a question of law, but rather disputed the arbitrator's factual findings.
The respondent was awarded $1,250 in legal expenses for the appeal.
Application for arbitration dismissed as the applicant failed to comply with statutory limitation periods.
The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.
The insurer denied the claims.
The applicant applied for mediation and subsequently for arbitration.
The insurer raised a preliminary issue that the applications were filed beyond the limitation periods set out in the Insurance Act and the Statutory Accident Benefits Schedule.
The arbitrator found that the applicant failed to comply with both the two-year limitation period to apply for mediation and the 90-day limitation period to apply for arbitration after the mediator's report.
The application for arbitration was dismissed.
