19 total
Insured awarded additional contents value but insurer entitled to depreciation set-off for building larger replacement home.
The plaintiff's home and its contents were destroyed in a fire.
The plaintiff had a $1,000,000 home insurance policy with the defendants.
The defendants paid out over $834,000, but the plaintiff sought the remainder of the policy limits, claiming additional construction costs, administrative expenses for acting as his own general contractor, additional living expenses, and higher valuations for his destroyed contents, including an art collection.
The plaintiff also sought general damages.
The court found that because the plaintiff chose to build a significantly larger home rather than replacing his original home, he was only entitled to the actual cash value of the original home, entitling the defendants to a set-off for depreciation.
The court dismissed the claims for administrative expenses, additional living expenses, and general damages, finding the plaintiff responsible for construction delays and the insurer's conduct reasonable.
The court awarded the plaintiff an additional $74,936.49 for the contents of the house, resulting in a net judgment of $25,468.64 after applying the defendants' set-off.
The plaintiff was awarded $9,688.42 in partial indemnity costs following a dismissed summary judgment motion.
This endorsement addresses the costs of an unsuccessful summary judgment motion brought by the defendant Andrew Ferri seeking dismissal of the plaintiff's claim.
The motion was dismissed, making the plaintiff the successful party.
The plaintiff sought costs on a partial indemnity basis, while the defendant argued costs should be deferred to the trial judge.
The court, applying Rule 57.01(1) of the Rules of Civil Procedure, found the plaintiff was entitled to costs.
Considering the factors, including the defendant's self-representation but prior legal counsel, the court fixed costs at $9,688.42, inclusive of disbursements and HST, to be paid by Andrew Ferri to the plaintiff within 30 days.
Summary judgment was dismissed due to triable issues regarding alleged forgery and corporate authority.
The defendant, Andrew Ferri, brought a motion for summary judgment seeking dismissal of the plaintiff's claim.
Ferri argued that the plaintiff corporation's representative lacked authority to commence the action, alleging that the true principal shareholder had not authorized it and that a key affidavit was forged or obtained through misrepresentation.
The plaintiff, 1238915 Ontario Limited, contended that there were significant triable issues and credibility disputes.
The court found numerous genuine issues requiring a trial, including allegations of forgery and misrepresentation, which could not be resolved on a summary judgment motion.
Consequently, the motion for summary judgment was dismissed.
Unqualified solicitor undertaking bound counsel to protect the adjuster's full fee.
On competing summary judgment motions arising from a fire insurance claim, the plaintiff public adjuster sought recovery of unpaid fees under an insured's retainer, irrevocable payment direction, and an alleged solicitor's undertaking.
The court held the insurer was not liable because the plaintiff had directed that payments be made to the law firm in trust, thereby amending any prior direction or equitable assignment.
However, the court found the lawyer's email undertaking to “protect your fee” was unqualified, applied to the plaintiff's fees in their entirety, and was reasonably relied on by the plaintiff.
Summary judgment was granted to the plaintiff against the insureds, the lawyer, and the law firm jointly and severally for $112,097.46, and the action against the insurer was dismissed.
Appeal allowed and administrative dismissal set aside due to Master's errors in assessing affidavit evidence.
The appellant appealed a Master's decision dismissing her motion to set aside a Registrar's order that had dismissed her personal injury action as abandoned.
The Divisional Court found that the Master made palpable and overriding errors by concluding that the appellant's counsel's affidavit had no evidentiary value and by finding prejudice to the respondent based on the expiration of the limitation period.
The court allowed the appeal, quashed the Master's decision, and ordered the Registrar's dismissal order set aside.
Substantial indemnity costs awarded after vexatious litigant declaration.
Following a successful application declaring the respondent a vexatious litigant under s. 140 of the Courts of Justice Act, the court determined the appropriate costs award.
The applicant sought substantial indemnity costs of $38,475 for the vexatious litigant application.
The respondent argued costs should be minimal or deferred due to impecuniosity and pending related actions.
The court held that substantial indemnity costs were justified due to the respondent’s conduct in prosecuting the underlying actions that prompted the vexatious litigant application.
Costs of $38,475 were awarded to the applicant on a substantial indemnity basis, payable in any event of a related action upon its completion.
Lump sum settlement from a long-term disability carrier is not deductible from accident benefits.
The applicant was struck by an uninsured driver and applied for accident benefits from the Motor Vehicle Accident Claims Fund (MVAC Fund).
The applicant had previously settled a lawsuit against her long-term disability carrier, Great West Life (GWL), for a lump sum of $150,000.
The MVAC Fund brought a motion to determine whether the GWL settlement was deductible from any accident benefits owing under s. 267.8 of the Insurance Act or s. 22 of the Motor Vehicle Accident Claims Act.
The arbitrator found that the settlement funds were paid to settle a legal obligation rather than as a payment under an income continuation benefit plan.
As there was no evidence breaking down the settlement funds to past benefits owing, the arbitrator concluded the settlement was not deductible under either statute.
Application for non-earner benefits dismissed as applicant did not suffer complete inability to carry on normal life.
The applicant, who had pre-existing mobility and health issues and used a motorized scooter, was involved in two motor vehicle accidents.
She applied for non-earner benefits from the insurers, claiming a complete inability to carry on a normal life.
The arbitrator found that while the applicant experienced pain and some functional limitation for a few months, she continued to live basically the same life as she had prior to the accidents, including driving her scooter, relying on meals on wheels, and eventually returning to social activities.
The application for non-earner benefits was dismissed, as the applicant failed to meet the stringent statutory test of being continuously unable to engage in substantially all of her pre-accident activities.
Judicial review dismissed; headstand on a party bus stripper pole reasonably found to be an 'accident'.
The applicant insurer sought judicial review of a Financial Services Commission of Ontario decision finding that the respondent was injured in an 'accident' under the Statutory Accident Benefits Schedule.
The respondent was injured while attempting a headstand on a 'stripper pole' inside a mobile party bus.
The Divisional Court applied a reasonableness standard of review and upheld the decision, finding it was reasonably open to the decision-maker to conclude that, given the specific nature of the vehicle, the headstand constituted an ordinary use of the vehicle and did not break the chain of causation.
The application for judicial review was dismissed.
Injury from attempting a headstand on a party bus stripper pole constitutes an accident under SABS.
The respondent suffered catastrophic injuries when he attempted a headstand against a stripper pole in a moving party limo bus.
The insurer appealed the Arbitrator's decision that the incident was an 'accident' under the Statutory Accident Benefits Schedule.
The Director's Delegate dismissed the appeal, finding that the Arbitrator did not err in concluding that the incident met the Amos purpose test and the Chisholm causation test, as the activities around the stripper pole were part of the ordinary and well-known use of that specific party vehicle.
Attempted headstand on a moving party bus stripper pole qualifies as an accident for statutory benefits.
The applicant was catastrophically injured when he attempted a headstand against a stripper pole in a moving party bus and fractured his neck.
The insurer denied statutory accident benefits, arguing the incident was not an 'accident' under the Schedule.
The arbitrator found that the use of the party bus and its amenities, including the pole, was an ordinary and well-known use of that specific type of vehicle.
The arbitrator concluded that the use or operation of the vehicle directly caused the impairment, satisfying both the purpose and causation tests.
The incident was deemed an accident within the meaning of the Schedule.
Applicant's catastrophic impairment was caused by pre-existing degenerative condition, not the motor vehicle accident.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits, claiming he was catastrophically impaired due to severe cervical spondolytic myelopathy causing quadriparesis.
The insurer denied the claim.
The arbitrator found that while the applicant suffered from a catastrophic impairment, it was not caused or materially contributed to by the motor vehicle accident.
The evidence demonstrated that the applicant's neurological decline was a result of the natural progression of his pre-existing degenerative condition, as his symptoms did not abruptly worsen immediately following the accident.
Appeal dismissed with costs as the court agreed with the lower court's reasons.
The appellant appealed the judgment of Justice Spence of the Superior Court of Justice.
The Court of Appeal agreed with the reasons and conclusions of the lower court judge and dismissed the appeal, awarding costs to the respondent.
Income replacement benefits for an applicant employed for only one week are based strictly on actual earnings.
The applicant was injured in a motor vehicle accident one week after starting a new job as a superintendent.
She applied for income replacement benefits.
The insurer calculated her benefits based only on the $308 she earned in the four weeks preceding the accident, resulting in a weekly benefit of $59.69.
The applicant argued her benefits should be extrapolated to reflect her annual salary of $16,000.
The arbitrator held that under the Statutory Accident Benefits Schedule, the income must be based on the amount actually earned in the four weeks prior to the accident, confirming the $59.69 weekly benefit.
The issues of repayment of caregiver benefits and expenses were adjourned for an evidentiary hearing.
Insurer ordered to pay income replacement benefits and a 35% special award for unreasonable delay.
The applicant, a self-employed pedorthist, was injured in a motor vehicle accident and claimed statutory accident benefits.
The insurer disputed her entitlement to income replacement benefits, arguing she was not substantially disabled and disputing the calculation of her post-accident business expenses.
The arbitrator found the applicant suffered a mild traumatic brain injury and was substantially disabled until October 1995.
The arbitrator allowed most of the applicant's post-accident business expenses, finding they were reasonably incurred to prevent a loss of revenue in her expanded business, but denied her claim for loss of profits.
The arbitrator also awarded various medical and rehabilitation benefits, including psychological counselling and a treadmill.
A special award of 35% was imposed against the insurer for unreasonably delaying and withholding benefits, particularly psychological counselling, despite recommendations from multiple assessors.
Insurer's appeal dismissed; claimant's personal problems and lack of prejudice constituted reasonable excuse for late claim.
The appellant insurer appealed an arbitration decision finding that the respondent claimant had a reasonable excuse for failing to notify the insurer of his accident benefits claim within 30 days of the accident.
The claimant's application was submitted nearly 18 months late due to a combination of personal problems and his first lawyer's failure to advance the claim.
The Director's Delegate upheld the arbitrator's finding that the claimant's personal circumstances constituted a reasonable excuse and that the insurer was not prejudiced by the delay, as the claimant's history of non-compliance meant earlier intervention would not have altered his recovery.
The appeal was dismissed.
Late notice of accident benefits claim excused due to applicant's personal circumstances and lack of prejudice.
The applicant was injured as a pedestrian in a motor vehicle accident and gave initial notice of his claim for statutory accident benefits 18 months later.
The insurer argued the claim was invalid due to non-compliance with the 30-day notice provision.
The arbitrator found that the applicant had a reasonable excuse for the delay, citing his substance abuse, incarceration, homelessness, and reliance on legal counsel who failed to notify the insurer.
The arbitrator also found no prejudice to the insurer, as the applicant's history of non-compliance with medical advice meant early intervention by a rehabilitation caseworker would not have altered his recovery.
Arbitrator awards limited income benefits for post-surgery recovery and specific rehabilitation expenses.
The applicant was injured in a motor vehicle accident and received statutory accident benefits until the insurer terminated them.
He applied for arbitration seeking ongoing weekly income benefits and supplementary medical and rehabilitation expenses.
The arbitrator found that the applicant was reasonably suited for teaching and thus not entitled to ongoing income benefits under section 12(5)(b), except for a six-month recovery period following back surgery.
The arbitrator also awarded limited case management services and a six-month diet program, but denied a special award, finding the insurer had not unreasonably withheld payments.
Care benefits limited to post-surgery recuperation period; prior disability benefits do not constitute employment income.
The applicant was injured in a motorcycle accident and claimed statutory accident benefits, including care benefits for his wife who took time off work to care for him, and weekly income benefits.
The arbitrator found that the applicant required full-time care only during his two-month recuperation from spinal surgery, awarding care benefits for that period but denying them thereafter, as his ongoing vertigo and orthopaedic injuries did not necessitate 24-hour supervision.
On the issue of income benefits, the arbitrator held that the applicant's prior workers' compensation and no-fault benefits did not constitute 'income from employment', meaning his weekly benefits had to be calculated based on the statutory deemed minimum earnings.
The arbitrator remained seized of the insurer's claim for repayment of an alleged overpayment pending a pending Divisional Court ruling.