3 total
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline.
The applicant was injured in a motorcycle accident and sought medical and rehabilitation benefits.
The respondent denied the benefits, arguing the injuries fell within the Minor Injury Guideline (MIG).
The applicant argued her injuries, including a partial tendon tear and chronic pain, warranted removal from the MIG.
The Tribunal found that the applicant's physical injuries met the definition of a minor injury and that she failed to establish chronic pain under the AMA Guides criteria.
As the $3,500 MIG limit was exhausted, the disputed treatment plan was not considered, and the application was dismissed.
Court awards damages for bar assault after defendants default.
In a personal injury action arising from an assault at a bar, the defendants had been noted in default and liability was previously determined.
The court conducted an undefended trial to assess damages after the plaintiff was struck in the face by a thrown beer bottle and suffered a facial laceration, post‑concussion syndrome, ongoing headaches, and psychological anxiety related to social settings.
Considering comparable assault cases and the lasting physical scar and emotional effects, the court awarded non‑pecuniary general damages.
The court also ordered reimbursement of subrogated claims relating to compensation paid by the Criminal Injuries Compensation Board and health care costs paid by OHIP, along with pre‑judgment interest.
Substantial indemnity costs were awarded given the defendants’ failure to participate and the victim‑related statutory considerations.
Arbitration application dismissed as statute-barred; insurer's conduct did not estop reliance on limitation period.
The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.
The insurer denied income replacement benefits in November 2005.
The applicant applied for mediation in January 2008, beyond the two-year limitation period.
The applicant argued the initial denial was invalid because he had not yet claimed the benefits, and alternatively, that the insurer was estopped from relying on the limitation period due to its delay in responding to a later inquiry.
The arbitrator found the initial denial was valid and the insurer's conduct did not amount to estoppel.
The application was dismissed as statute-barred.
