Lisa Bishop

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that awarded a 15% special award under section 10 of O. Reg. 664 but failed to address the mandatory interest on that award.

The adjudicator found that the failure to specify that interest was payable on the lump sum award was an error of law, as section 10 interest is mandatory and distinct from the discretionary lump sum component.

The decision was varied to include entitlement to interest in accordance with Reg. 664, but the adjudicator declined to quantify the exact amount owing due to insufficient information.

The applicant sought a determination that he sustained a catastrophic impairment under Criterion 8 of the Schedule following a 2017 motor vehicle accident.

The Tribunal found that while the applicant suffered from accident-related mental and behavioural disorders, he did not sustain a marked impairment in the spheres of activities of daily living or social functioning.

The Tribunal preferred the evidence of the respondent's assessors, noting the applicant maintained independence in personal care and continued to have meaningful social interactions with family and friends.

The claims for unapproved balances of assessment plans, interest, and an award were also dismissed.

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

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

The applicant argued she sustained a concussion, chronic pain, and psychological impairments warranting removal from the MIG.

The Tribunal found that the medical evidence, including largely normal diagnostic imaging and the applicant's return to full-time work, did not support a concussion, disabling chronic pain, or a standalone psychological impairment.

The Tribunal concluded the applicant's injuries were predominantly minor and subject to the MIG limit.

Consequently, the disputed treatment plans were not payable, and claims for interest and a special award were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, attendant care benefits, and numerous treatment plans for psychological, cognitive, and occupational therapy assessments and services.

The Tribunal found the claim for the non-earner benefit was statute-barred because the applicant failed to dispute the insurer's clear and unequivocal denial within the two-year limitation period.

The Tribunal dismissed the claims for the treatment plans and attendant care benefits, finding the applicant failed to prove they were reasonable and necessary for accident-related injuries, largely due to significant pre-existing psychological conditions and a lack of supporting medical evidence.

Claims for interest and an award for unreasonable delay were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including attendant care benefits, occupational therapy, a home modification assessment, and psychological services.

The Licence Appeal Tribunal dismissed the application in its entirety.

The Tribunal found the applicant's credibility was significantly impacted by his failure to disclose a pre-existing right knee impairment to assessors.

Surveillance evidence and inconsistent self-reports further undermined his claims for attendant care and occupational therapy.

The Tribunal also found the applicant had not utilized previously approved psychological treatment, failing to prove the necessity of additional sessions.

Claims for interest and a special award were consequently dismissed.

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

The respondent partially denied a treatment plan for occupational therapy and assistive devices, claiming lower retail prices were available but failing to provide evidence.

The respondent later approved the balance of the treatment plan after the applicant applied to the Tribunal.

The Tribunal awarded the applicant interest on the overdue balance from the date of the application to the date of settlement.

The Tribunal also ordered the respondent to pay an award of 15% of the disputed treatment plan amount, finding that the respondent unreasonably withheld payment by failing to comply with the Superintendent's Guideline regarding proof of retail prices.

The respondent insurer raised a preliminary issue arguing that the applicant was barred from proceeding with her claim for statutory accident benefits due to res judicata and failure to attend section 44 insurer's examinations.

The Tribunal found that issue estoppel did not apply because the current application disputed different treatment plans than those addressed in a prior Tribunal decision.

Furthermore, the Tribunal held that the applicant was not non-compliant with section 44, as the insurer had never actually requested examinations for the specific treatment plans currently in dispute.

The applicant was permitted to proceed to a hearing on the substantive issues.

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

The respondent insurer denied benefits and argued the applicant was barred from proceeding with her application because she failed to attend multiple insurer's examinations.

The Tribunal found that the notices of examination provided by the respondent were deficient as they failed to include sufficient medical or other reasons as required by section 44(5) of the Schedule.

Consequently, the applicant was not barred from proceeding with her application.

The respondent's request for costs was dismissed.

The applicant sought $2,200 for an in-home occupational therapy assessment following a motor vehicle accident.

The insurer denied the benefit and scheduled an insurer's examination, which the applicant failed to attend without reasonable explanation.

The Tribunal found the applicant was statute-barred from proceeding under s. 55(1)(2) of the Schedule due to her non-attendance.

In the alternative, the Tribunal found the assessment was not reasonable or necessary, as it was a duplication of previously approved services and the applicant's ongoing physical complaints were not clearly linked to the accident.

The application was dismissed.

This ruling addresses three requests by the plaintiffs for specific jury instructions during a civil trial concerning a motor vehicle accident.

The court granted the request for a standard instruction on rear-end collisions, finding sufficient evidence for the jury to consider it.

The request for a mandatory adverse inference against the defendant for failing to testify was granted in principle, but the court clarified that such an inference can only be drawn if the plaintiff first establishes a prima facie case.

The request for a mandatory adverse inference against the defence for not calling a psychiatric expert was denied, with the court distinguishing the applicable law in Ontario from British Columbia and emphasizing that both parties had the power to call the expert.

This trial ruling addresses the admissibility and content of Ms. Pollard's summary charts for future care costs in two personal injury actions.

The court clarified the scope of Ms. Pollard's expert qualifications, limiting her opinions to unit costs and excluding recommendations on specific treatments, dosages, or frequencies unless supported by qualified medical evidence.

The ruling provides guidance on what items can be included in the summary charts for jury consideration, emphasizing the need for "reasonable evidence" and distinguishing between expert opinion and jury common sense.

This ruling addresses jury questions in two consolidated personal injury actions.

The court clarified the distinct concepts of future loss of income, loss of earning capacity, and loss of competitive advantage, explaining how they relate to claims for future income loss depending on the plaintiff's ability to return to work.

It also confirmed the retention of questions regarding past and future housekeeping and future healthcare costs for jury deliberation, while removing past health care costs by consent.

The court issued a ruling on the formulation of jury questions in a civil trial involving a motor vehicle accident.

The judge addressed disagreements between the plaintiff and defendant counsel regarding the wording and inclusion of specific questions.

Key determinations included the necessity of separate questions for past versus future losses and different damage types, the appropriateness of using the term "negligent" rather than "liable" the requirement for a distinct causation question, and the decision to exclude a question asking for particulars of negligence, given the straightforward nature of the rear-end collision case.

In a personal injury trial, the defendants brought a motion to exclude the evidence of the plaintiffs' future care expert, Yvonne Pollard.

The defendants argued that Ms. Pollard's reports lacked factual foundation because they relied heavily on opinions from medical experts whom the plaintiffs had previously elected not to call, following a prior ruling limiting the number of duplicative experts.

The plaintiff, Kenisha Desmond, argued that Ms. Pollard's reports had an admissible factual basis and that her evidence was crucial for future care costs.

The court denied the defendants' motion, finding that sufficient evidentiary foundation existed from other called experts and potentially from future witnesses.

However, the court clarified that the plaintiff could not introduce reports from the uncalled, duplicative experts through Ms. Pollard, as they would constitute inadmissible hearsay.

This ruling addresses the plaintiffs' motion for leave to call more than three medical experts in a personal injury trial, as permitted under Section 12 of the Evidence Act.

The court reviewed the proposed experts for both plaintiffs, Kenisha Desmond and Shian Henry, and found significant overlap and duplication in their anticipated testimony, particularly among medical specialists.

Applying the criteria for granting leave and emphasizing the court's gatekeeping function to prevent unnecessary trial length and disproportionate costs, the judge granted leave to call only one expert from each identified group of duplicative specialists for both plaintiffs, while allowing economic and occupational therapy experts.

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

The respondent insurer raised a preliminary issue that the applicant was barred from proceeding with her claim for income replacement benefits (IRBs) and one occupational therapy treatment plan because she failed to attend scheduled insurer's examinations (IEs).

The Tribunal found that the insurer provided valid notices of examination with sufficient medical reasons, and that the IEs were reasonably necessary to assess the post-104-week IRB test.

Consequently, the applicant was barred from proceeding with those claims under s. 55(1)2 of the Schedule.

However, the Tribunal found the applicant was entitled to two other occupational therapy treatment plans because the insurer's denial notices failed to provide clear and specific medical reasons as required by s. 38(8) of the Schedule.

The applicant's request for a special award under Regulation 664 was dismissed.

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

The respondent denied the medical benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and paid IRBs at a rate of $59.00 per week rather than the $800.00 claimed.

The Tribunal found that the applicant sustained psychological injuries, removing him from the MIG, but dismissed the claim for the disputed treatment plan as it was not shown to be reasonable and necessary.

The Tribunal also found that the applicant failed to prove his self-employment income and losses to support an IRB quantum of $800.00 per week, preferring the respondent's calculation of $59.00 per week.

Claims for interest and an award were dismissed.

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

The respondent denied medical benefits beyond the $3,500 Minor Injury Guideline cap.

The Tribunal found that the applicant's physical and psychological injuries were predominantly minor and treatable within the Guideline.

As the funding limit was exhausted, the claims for additional medical benefits and assessments were dismissed.

Furthermore, the Tribunal ordered the applicant to repay $372.21 for an overpayment of income replacement benefits.

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident, claiming a substantial inability to perform the essential tasks of his pre-accident self-employment in renovation and landscaping.

The Tribunal found that the applicant failed to provide objective medical evidence demonstrating that his accident-related impairments prevented him from working.

The medical evidence primarily showed minor contusions and soft tissue injuries, and an insurer's examination concluded he did not suffer a substantial inability to work.

The application for IRBs, interest, and an award was dismissed.

The respondent insurer requested a reconsideration of a decision awarding the applicant income replacement benefits, interest at 2 percent per month, and a 35 percent special award under Regulation 664.

The insurer argued the adjudicator erred in finding it had received the applicant's employment file by August 2018 via email.

Upon reconsideration, the adjudicator found that the email containing the employment file was sent to an adjuster who had not consented to electronic delivery, contrary to the requirements of the Statutory Accident Benefits Schedule and the Electronic Commerce Act, 2000.

As proper delivery was not effected, the insurer's delay in paying benefits was reasonable.

The request for reconsideration was granted, and the orders for the special award and 2 percent interest were rescinded.