Naresh Misir

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to non-earner benefits, various treatment plans, and removal from the Minor Injury Guideline (MIG) due to chronic pain, psychological impairments, and pre-existing conditions.

The adjudicator found that the applicant did not suffer a complete inability to carry on a normal life, relying on inconsistencies in the medical records and evidence of the applicant's ability to perform activities of daily living.

The adjudicator also declined to remove the applicant from the MIG, preferring the respondent's psychological assessment which indicated malingering, and finding insufficient evidence of chronic pain with functional impairment.

As the MIG limits were exhausted, the claims for treatment plans, an award, and interest were dismissed.

The appellant appealed GST/HST assessments for reporting periods between 2009 and 2012.

The appellant argued that its supply of independent medical assessment reports to insurance companies was an exempt supply of an 'institutional health care service' made by the operator of a 'health care facility'.

The Tax Court of Canada held that the appellant did not operate a health care facility because it did not provide medical or hospital care, and the individuals assessed were not patients of the facility.

The Court also upheld gross negligence penalties for the appellant's failure to charge and remit HST, finding the appellant was recklessly indifferent to its tax obligations.

Finally, the Court denied additional input tax credits due to a lack of prescribed supporting documentation.

The appeal was dismissed.

The applicant sought statutory accident benefits following a 2010 motor vehicle accident, claiming catastrophic impairment and non-earner benefits.

The applicant had significant pre-existing conditions, including severe rheumatoid arthritis and injuries from a 2009 accident.

Following an appeal that remitted the issues for re-hearing, the arbitrator found that the applicant failed to meet the 'but for' test for causation.

The evidence demonstrated that her ongoing impairments and subsequent surgeries were the result of her pre-existing degenerative conditions rather than the 2010 accident.

Consequently, the claims for catastrophic impairment and non-earner benefits were denied.

The insurer appealed the Arbitrator's finding that the insured sustained a catastrophic impairment, arguing the Arbitrator applied the wrong causation test.

The insured cross-appealed the denial of Non-Earner Benefits, Housekeeping, and Attendant Care Benefits.

The Director's Delegate held that the 'but for' test, not the 'material contribution' test, is the correct causation test in accident benefits cases.

The Delegate found the Arbitrator misapprehended critical evidence regarding both the catastrophic impairment and Non-Earner Benefits claims, and remitted those issues for re-hearing.

The denial of Housekeeping and Attendant Care Benefits was upheld as the Arbitrator reasonably found the expenses were not incurred.

The applicant sought statutory accident benefits following a 2010 motor vehicle accident, claiming catastrophic impairment, attendant care, housekeeping, and non-earner benefits.

The insurer argued the applicant's impairments were solely due to pre-existing rheumatoid arthritis.

The arbitrator found the accident was a material contributing factor to the applicant's catastrophic impairment, relying on expert medical and psychological evidence.

However, the claims for attendant care and housekeeping benefits were dismissed because the applicant failed to provide documentary evidence that her service providers suffered an economic loss.

The claim for non-earner benefits was also dismissed due to insufficient evidence comparing pre- and post-accident activities.

The applicant was awarded $3,100 for the cost of examinations.

The appellants appealed an order dismissing their motion to set aside a default judgment in a slip and fall action.

The appellants claimed they only learned of the action when enforcement proceedings began, 12 years after the incident.

The Court of Appeal upheld the motion judge's finding that the appellants had evaded service, failed to act promptly, lacked a plausible explanation for their delay, and presented a defence of dubious merit.

The appeal was dismissed.

Following an undefended trial in a negligence action arising from a slip and fall on a residential driveway, the court addressed the issue of costs after releasing its reasons for judgment.

The successful plaintiff sought recovery of legal fees and disbursements.

Applying s. 131(1) of the Courts of Justice Act and the factors in Rule 57.01(1) of the Rules of Civil Procedure, the court noted that a successful party is generally entitled to costs absent compelling reasons to deny them.

The court characterized the matter as relatively straightforward and allowed partial indemnity fees of $15,000 inclusive of HST and disbursements of $27,512.32 inclusive of HST.

The Applicant was injured in a motor vehicle accident and claimed caregiver benefits for the care of her elderly parents.

The Insurer denied the claim on the basis that the Applicant did not 'reside with' her parents, as she lived in a different apartment within the same building.

On a preliminary issue hearing, the Arbitrator found that the Applicant had moved to the building specifically to care for her parents and provided ongoing care.

Applying a liberal interpretation consistent with the consumer protection purpose of the Schedule, the Arbitrator concluded that the Applicant was 'residing' with her parents at the time of the accident and was not precluded from claiming caregiver benefits.

The Registrar issued a Notice of Proposal to suspend the licensee's liquor licence following an incident where a fight occurred on the premises and two patrons were hit with beer bottles.

The parties submitted an Agreed Statement of Facts admitting a breach of subsection 45(1) of O. Reg. 719/90.

The Board accepted the joint submission and ordered a 14-day suspension of the liquor licence.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for caregiving and housekeeping expenses.

The insurer terminated these benefits based on in-home assessments and independent medical examinations indicating the applicant was not substantially disabled.

The applicant submitted invoices for services allegedly provided by her sister and a neighbour.

The arbitrator found the invoices to be unreliable and fabricated, noting they contradicted the applicant's own statements to assessors and the testimony of the service providers.

The application for benefits and a special award was dismissed, and the insurer was awarded its expenses of the arbitration proceeding.

The appellant was injured in a motor vehicle accident in the course of his employment.

He claimed and received statutory accident benefits but did not claim workers' compensation benefits.

After his accident benefits were terminated, he commenced a tort action just days before an arbitration pre-hearing.

The arbitrator found that the appellant's election to bring a tort action was made primarily for the purpose of claiming accident benefits, precluding him from relying on the exception in subsection 59(2) of the SABS-1996.

The Director's Delegate dismissed the appeal, finding no error in the arbitrator's consideration of the appellant's failure to pursue the tort claim as evidence of his primary purpose.

The applicants, a husband and wife, were injured in a motor vehicle accident and sought statutory accident benefits from their insurer.

The insurer denied claims for caregiver benefits, housekeeping and home maintenance services, medical benefits, and transportation expenses.

The arbitrator found that both applicants suffered impairments that substantially prevented them from performing their pre-accident housekeeping and caregiving duties.

The arbitrator ordered the insurer to pay the claimed medical, transportation, housekeeping, and caregiver benefits, finding the expenses to be reasonable and necessary.

The applicant was injured in a motor vehicle accident while in the course of his employment.

He applied for statutory accident benefits from the insurer, claiming he had elected to opt out of the Workplace Safety and Insurance Act (WSIA) scheme to pursue a tort action.

The insurer argued the election was invalid because it was made primarily to claim statutory accident benefits, contrary to section 59(2) of the Schedule.

The arbitrator found that the applicant and his paralegal took no meaningful steps to pursue a tort action for over two years, ignored correspondence from the insurer regarding the tort claim, and only issued a Statement of Claim after the insurer sought repayment of benefits.

The arbitrator concluded the election was not made primarily to pursue a tort action and was therefore invalid, entitling the insurer to repayment of benefits paid.

The respondent was severely injured after rolling out of his moving car on Highway 401 and jumping off a bridge onto Bayview Avenue.

The arbitrator found he suffered a panic attack while driving, which directly caused him to exit the car and leap, qualifying as an 'accident' under the SABS-1996.

On appeal, the Director's Delegate found the arbitrator failed to properly explain his preference for hearsay evidence regarding the panic attack and failed to consider the respondent's testimony about his actions after leaving the car.

The appeal was allowed and the matter remitted for a new hearing.

The applicant sought income replacement benefits following a motor vehicle accident.

The insurer refused to pay, arguing the applicant failed to provide necessary financial information to assess the claim, as required by section 33 of the Statutory Accident Benefits Schedule.

At the arbitration hearing, the applicant's newly retained counsel requested an adjournment to produce tax returns that had been requested for over two years.

The arbitrator denied the adjournment and refused to admit the late-produced documents into evidence, finding the delay was avoidable and the applicant had engaged in tactical brinkmanship.

The claim for income replacement benefits was dismissed, and the applicant was ordered to pay the insurer's arbitration expenses.

The applicant suffered a panic attack while driving on Highway 401, causing him to exit his moving vehicle, run to the edge of the highway, and leap off the overpass onto the road below.

The insurer denied his application for statutory accident benefits, arguing the incident was not an 'accident' under the Schedule and that the panic attack was an intervening force.

The arbitrator found that the applicant's panic attack directly caused him to exit the vehicle and jump, with no break in the chain of events.

Applying the 'thin skull' principle, the arbitrator concluded the incident constituted an accident arising out of the use or operation of an automobile, entitling the applicant to claim benefits.