15 total
Claim for income replacement benefits and enhanced treatment rates dismissed due to insufficient evidence.
The applicant sought entitlement to income replacement benefits (IRBs) and various treatment plans following a motor vehicle accident.
The Licence Appeal Tribunal dismissed the claim for IRBs, finding the applicant failed to provide sufficient medical evidence or required employment information to establish a substantial inability to perform the essential tasks of his employment.
The Tribunal also denied the enhanced hourly rates sought for a psychotherapist and social worker, as well as the costs for progress reports, but awarded $200 for the cost of completing one treatment plan.
The claim for a special award under s. 10 of Regulation 664 was dismissed as there was no evidence of unreasonable delay by the insurer.
Appeal dismissed; LAT properly restricted chiropractor from providing psychological diagnoses for catastrophic impairment assessment.
The appellant was injured in an ATV rollover and applied for a determination of catastrophic impairment under the Statutory Accident Benefits Schedule.
The Licence Appeal Tribunal (LAT) found she was not catastrophically impaired, giving little weight to the impairment ratings of her chiropractor, who had offered psychological diagnoses beyond his scope of practice.
On appeal, the Divisional Court found no error of law in the LAT's treatment of the chiropractor's evidence, affirming that while a chiropractor may compile impairment ratings under the AMA Guides, they cannot provide medical diagnoses outside their expertise.
The appeal was dismissed.
Catastrophic impairment claim dismissed; marked impairment in adaptation attributed to pre-existing psychological conditions.
The applicant sought a determination that she sustained a catastrophic impairment under Criterion 8 (mental and behavioural disorders) following a motor vehicle accident.
The Tribunal found that while the applicant sustained a mild neurocognitive disorder and a specific phobia as a result of the accident, her impairments in activities of daily living, social functioning, and concentration, persistence and pace were only moderate (Class 3).
Although the applicant demonstrated a marked impairment (Class 4) in adaptation, the Tribunal concluded this was caused by severe pre-existing psychological limitations rather than the accident.
The application was dismissed.
Applicant awarded chiropractic benefits and interest after proving causation from initial accident; special award denied.
The applicant sought statutory accident benefits for chiropractic treatment following a 2017 motor vehicle accident.
The respondent denied the treatment plan, arguing that the injuries were caused by a subsequent 2018 accident and that the treatment was not reasonable and necessary.
The Tribunal found that the applicant satisfied the 'but-for' test for causation, as the medical evidence demonstrated ongoing injuries from the 2017 accident.
The Tribunal also found the treatment plan reasonable and necessary based on the supporting medical reports and clinical notes, giving little weight to the respondent's independent medical examination.
The applicant was awarded the cost of the treatment plan and interest, but the claim for a special award under s. 10 of Reg. 664 was dismissed as the respondent's conduct was not found to be unreasonable.
Reconsideration granted and new hearing ordered because original adjudicator failed to review properly filed medical evidence.
The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied a treatment plan for chiropractic services.
The applicant argued the Tribunal breached procedural fairness by ordering a written hearing without affidavit evidence and by failing to consider his filed evidence.
The Vice-Chair found no breach regarding the hearing format, as the Tribunal has the authority to control its procedure.
However, the Vice-Chair found a material breach of procedural fairness because the original adjudicator explicitly stated they could not locate the applicant's medical report, which had been properly filed and tabbed.
The reconsideration request was granted, the original decision cancelled, and a new written hearing ordered before a different adjudicator.
The 2016 SABS catastrophic impairment definition applies to transitional policies for accidents occurring after June 1, 2016.
The applicant was injured in a motor vehicle accident and sought a determination of catastrophic impairment.
The tribunal held a preliminary issue hearing to determine which version of the Statutory Accident Benefits Schedule applied to the applicant's transitional policy, and whether her claims were statute-barred.
The adjudicator found that the 2016 Schedule's definition of catastrophic impairment applied.
Applying section 7 of the Licence Appeal Tribunal Act, the adjudicator declined to extend the limitation period for the applicant's income replacement benefits claim due to incurable prejudice to the insurer, but extended the limitation period for her medical and rehabilitation benefits claims.
Application for assessment costs dismissed; insurer not required to pay provider travel expenses or exceed fee cap.
The applicant, who was catastrophically impaired in a motor vehicle accident, sought payment for various assessment costs under the Statutory Accident Benefits Schedule.
The insurer denied portions of the treatment plans on the basis that they exceeded the $2,000 cap per assessment under s. 25(5)(a) or were for provider travel expenses not covered under s. 25(4).
The Tribunal agreed with the insurer, finding that the applicant failed to demonstrate the reasonableness of the unapproved portions, including attempts to bifurcate assessments to circumvent the fee cap.
Medical benefits partially granted; one treatment plan statute-barred for failure to attend insurer's examination.
The applicant sought statutory accident benefits for physiotherapy, chiropractic treatment, and the cost of completing an OCF-18 following a motor vehicle accident.
The Tribunal found the $2,495.48 treatment plan reasonable and necessary to assist in the applicant's recovery.
However, the $3,260.64 treatment plan was dismissed as the applicant was statute-barred under s. 55 for failing to attend an insurer's examination.
The claim for the cost of completing the OCF-18 was also dismissed as it did not meet the criteria under s. 25(1)3.
The Tribunal declined to order an award under s. 10 of O. Reg. 664, finding no evidence that the insurer acted in bad faith.
Insurer ordered to pay $52,000 Special Award and over $39,000 in expenses for unreasonably delaying benefits.
Following a finding that the insurer unreasonably delayed payment of attendant care and medical benefits, the arbitrator determined the quantum of the Special Award and expenses.
The arbitrator awarded a Special Award of $52,000, finding the insurer's conduct blameworthy and noting the vulnerability of the insured.
The arbitrator also awarded the applicant $35,360.45 for arbitration expenses and $4,279.88 for the costs of the written hearing on these issues.
Plaintiff awarded $12,500 in partial indemnity costs after defendant abandoned summary judgment limitation period motion.
The defendant brought a motion for summary judgment to dismiss the plaintiff's motor vehicle accident claim based on the expiry of the limitation period.
On the eve of the motion, the defendant abandoned it, and the parties attended a hearing solely to determine costs.
The plaintiff sought costs on a substantial indemnity basis, arguing the motion was unreasonable from the outset because the permanency of her injuries was not discoverable until a later medical report was obtained.
The court found no reason to depart from the presumption under Rule 37.09(3) that the responding party is entitled to costs of an abandoned motion.
However, the court declined to award substantial indemnity costs, finding no bad faith or egregious conduct by the defendant.
Costs were fixed at $12,500 on a partial indemnity basis.
Appeal dismissed; concurrent tort liability finding made alleged charge errors immaterial.
Following a jury verdict apportioning fault for a motor vehicle accident between two motorcyclists, the appellant challenged the trial judge’s jury instructions on causation, joint tortfeasor liability, and concurrent liability.
The court held that any alleged error concerning joint tortfeasor instructions was immaterial because the jury’s answers clearly established liability as a concurrent tortfeasor, and the evidence supported that route to liability.
The court also rejected the argument that the charge was unbalanced or unfair when read as a whole.
It further upheld the dismissal of a post-verdict Rule 21.01 motion concerning insurance coverage, holding that the issue could properly proceed in a separate action.
Appeal allowed and solicitor reinstated; contacting non-party corporate counsel did not breach professional conduct rules.
The plaintiffs appealed an interlocutory order removing their solicitor of record for allegedly improper conduct.
The solicitor had contacted corporate counsel for a non-party (Cineplex) to clarify ownership issues regarding the premises where the plaintiff's slip and fall occurred.
The Divisional Court allowed the appeal and reinstated the solicitor, finding that the motions judge mischaracterized the legal test and misconstrued the facts.
The court held that the Rules of Professional Conduct prohibiting contact with represented parties did not apply, as the non-party was not represented by the defendant's counsel and no confidential information was discussed.
Appeal allowed; plaintiff's lawyer reinstated as solicitor of record after being improperly removed for contacting a non-party.
The plaintiff appealed an interlocutory order removing their lawyer as solicitor of record in a slip-and-fall action.
The motion judge had found the lawyer's conduct in contacting corporate counsel of a non-party to be imprudent and in breach of the Rules of Professional Conduct.
The Divisional Court allowed the appeal, finding that the non-party was not represented by the defendant's counsel and there was no conflict of interest.
The court held that the motion judge mischaracterized the test for removing a solicitor and that the lawyer's conduct did not bring public confidence in the justice system into question.
Appeal of lost profit calculation dismissed; trial judge entitled to accept plaintiff's expert evidence.
The appellant appealed a trial judgment awarding damages for lost profits arising from a breach of contract.
The appellant argued the trial judge erred in accepting the plaintiff's expert's historical approach to calculating lost profits and failed to consider whether lost advertisements were transferred to other accounts.
The Court of Appeal dismissed the appeal, finding the trial judge was entitled to accept the plaintiff's expert evidence and that the argument regarding transferred advertisements was not sufficiently developed in the evidence.
Leave to appeal granted on compelled expert report disclosure abrogating litigation privilege, but denied on storage costs.
The moving party, a defendant in a motor vehicle action, sought leave to appeal an interlocutory order that compelled the disclosure of any expert's report obtained from a joint vehicle inspection and required the parties to split outstanding storage costs.
The Divisional Court granted leave to appeal the disclosure order, finding good reason to doubt its correctness as it abrogated litigation privilege, which is a matter of public importance.
However, the court denied leave to appeal the storage costs order, characterizing it as a discretionary decision with no broader public importance.