Michael Henry

The applicant sought entitlement to a TENS machine for his foot and leg following a motor vehicle accident.

The respondent had approved a TENS machine for the applicant's back but denied the second machine due to a lack of supporting medical evidence.

The Tribunal found that the applicant failed to meet his burden of proving the second TENS machine was reasonable and necessary, as the medical documentation only recommended a TENS machine for his back.

The application was dismissed, and no interest was payable.

The applicant sought a determination that she sustained a catastrophic impairment under Criterion 8 of the Statutory Accident Benefits Schedule due to mental or behavioural disorders following a motor vehicle accident.

The Tribunal reviewed expert evidence and the applicant's self-reported activities, including maintaining sobriety, driving long distances, and regaining custody of her children.

The Tribunal preferred the respondent's experts, finding that the applicant's impairments in social functioning, concentration, persistence and pace, and adaptation did not reach the marked (Class 4) level required for a catastrophic impairment designation.

The application was dismissed.

The applicant, a pedestrian injured in a motor vehicle accident, applied for non-earner benefits after the respondent insurer terminated them.

The adjudicator applied the Heath test to determine whether the applicant suffered a complete inability to carry on a normal life.

Finding that the applicant's pain and physical limitations practically prevented her from engaging in substantially all of her pre-accident activities, including walking, housekeeping, and caring for her grandchildren, the adjudicator concluded she met the test.

The applicant was awarded ongoing non-earner benefits and interest on overdue payments.

The plaintiff, Valrose Taylor, brought an action for injuries sustained after falling on a City of Brampton bus due to sudden braking.

The parties agreed on damages, leaving only the question of liability.

The court examined the bus driver's standard of care, considering the sudden braking event caused by pedestrians running in front of the bus.

The court found the driver met the standard of care of a reasonable bus driver in the circumstances, as he had to brake immediately to avoid serious injury or death to the pedestrians.

The action was dismissed.

The plaintiffs brought a motion under Rule 7.08 of the Rules of Civil Procedure seeking court approval of a settlement involving a minor plaintiff arising from the death of her father in a motor vehicle accident.

The proposed settlement allocated $206,875 to the minor for loss of care, guidance and companionship under the Family Law Act.

The court found the settlement amount reasonable but raised significant concerns regarding counsel’s disclosure and the proposed solicitor‑client fees.

The materials were confusing and inconsistent, and the court concluded the firm had already been adequately compensated through costs recovered from the defendant and premiums charged to other plaintiffs.

The settlement was approved, but no further fees or disbursements were permitted to be deducted from the minor’s portion.

The appellant appealed an arbitration decision denying him ongoing income replacement benefits, the cost of a TENS machine, a higher mileage rate, and an increased special award following a motor vehicle accident.

The Director's Delegate upheld the arbitrator's finding that the appellant's ongoing disability was caused by severe pre-existing physical and psychological conditions, and that the accident did not materially contribute to his disability beyond March 1997.

The appeal was dismissed with respect to the income replacement benefits, TENS machine, and special award.

However, the Director's Delegate varied the arbitration order to allow mileage expenses at a rate of 22 cents per kilometre, up from the 13 cents paid by the insurer.

The applicant was injured in a motor vehicle accident and sought ongoing income replacement benefits and medical benefits.

The insurer terminated benefits, arguing the applicant's ongoing disability was caused by severe pre-existing psychological and physical conditions, not the accident.

The arbitrator found that while the accident caused moderate soft tissue injuries, it did not significantly contribute to the applicant's disability beyond the termination date.

Claims for ongoing income replacement and most medical benefits were dismissed.

However, the arbitrator awarded a $5,000 special award against the insurer for unreasonable delays in paying benefits and adjusting the claim following clarifications in the law.

The applicant was injured in a motor vehicle accident and received rehabilitation assistance from Trauma Services.

A dispute arose over the outstanding account, and an application for arbitration was filed.

The insurer raised a preliminary issue, arguing that the Commission lacked jurisdiction because the arbitration was actually brought by Trauma Services rather than the insured person.

The Arbitrator found that the applicant had authorized Trauma Services to access the mediation and arbitration processes on her behalf, and that she had properly retained counsel to proceed with the application.

The Arbitrator concluded that the arbitration was properly instituted by the applicant and that the Commission had jurisdiction to hear the matter.

The appellant insurer appealed an arbitrator's decision finding it liable to pay statutory accident benefits to the respondent, who was injured while driving a rented taxicab.

The respondent had a personal vehicle insured with the appellant but was not a named insured on the taxicab's fleet policy.

The appellant argued that its policy excluded coverage for vehicles used as taxicabs.

The Director's Delegate dismissed the appeal, holding that the broad definition of 'insured person' in the Statutory Accident Benefits Schedule prevailed over the exclusions in the standard owner's policy.

Furthermore, the respondent was not a named insured under the taxicab's policy for the purposes of the priority rules in section 268 of the Insurance Act.

The applicant was injured in a motor vehicle accident and received weekly income benefits until they were terminated by the insurer.

The applicant sought arbitration, claiming ongoing physical and psychological disability preventing him from working as a taxi driver.

The arbitrator found the applicant lacked credibility due to inconsistencies in his testimony and reliable medical records indicating pre-existing conditions.

The medical evidence did not establish an objective physical basis for his ongoing pain complaints, nor did it prove his psychological issues were caused by the accident.

The claim for ongoing weekly income benefits was dismissed, though the arbitrator confirmed the correct quantum of benefits was $540.00 per week and awarded the applicant his arbitration expenses.

The applicant was injured in a motor vehicle accident while driving a taxi.

He applied for statutory accident benefits from the insurer of the taxi, who denied the claim and referred him to the insurer of his personal vehicle.

A priority dispute arose between the two insurers regarding which was liable to pay the benefits.

The arbitrator determined that the applicant was an 'insured' under both policies, but was only a 'named insured' under his personal vehicle's policy for the purposes of section 268(5) of the Insurance Act.

Consequently, the insurer of the applicant's personal vehicle was held liable to pay the statutory accident benefits.