Matthew Wasserman

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming $2,000 for an executive summary related to a catastrophic impairment assessment.

The Licence Appeal Tribunal found that the executive summary constituted a separate, reasonable, and necessary assessment, ordering the respondent to pay the benefit with interest.

However, the Tribunal dismissed the applicant's claims for an award under section 10 of O. Reg. 664 and for breach of good faith, finding the respondent's initial denial was not unreasonable.

The Tribunal awarded $250 in costs to the respondent due to the applicant's frivolous threat of a contempt motion.

The applicant, who was catastrophically impaired following a motor vehicle accident, sought entitlement to various statutory accident benefits including home modifications, assistive devices, and medications.

The Licence Appeal Tribunal dismissed the application in its entirety.

The claim for home modifications was denied under s. 38(2) of the Schedule because the expenses were incurred before the treatment plan was submitted.

The claims for a bathmat, blender, and various supplements were dismissed as the applicant failed to establish they were reasonable and necessary or causally related to the accident.

Claims for interest, a s. 10 award, and costs were also dismissed.

The applicant sought statutory accident benefits for home modifications totaling $777,467.00 following a motor vehicle accident that resulted in a spinal cord injury.

Prior to the submission of the treatment plan, the applicant's family sold their pre-accident home and purchased a new bungalow.

The Tribunal found that the proposed modifications were for a home the applicant no longer resided in, and no assessment was provided for the new bungalow.

The Tribunal dismissed the application, concluding the applicant failed to prove the modifications were reasonable and necessary, and denied claims for interest and a special award.

The applicant insurer sought repayment of $3,488.92 in medical and rehabilitation benefits paid to the respondent, alleging wilful misrepresentation.

In a prior hearing, the Tribunal determined the respondent was not a passenger in the vehicle involved in the subject accident.

The adjudicator found the respondent committed wilful misrepresentation by falsely claiming to be in the accident.

The adjudicator also found the insurer's repayment notices were sufficient, despite improperly including claims for insurer's examination expenses.

The respondent was ordered to repay $3,488.92 plus interest.

The applicant was involved in a motor vehicle accident and sought $2,170.28 for an occupational therapy treatment plan under the Statutory Accident Benefits Schedule.

The respondent denied the benefit, relying on insurer's examinations which concluded the applicant had reached maximum medical recovery and that further treatment was not reasonable or necessary.

The Tribunal found that the applicant failed to provide compelling medical evidence to establish the treatment plan was reasonable and necessary, noting that the applicant's chiropractor was not qualified to diagnose chronic pain syndrome.

The application was dismissed, and no interest was awarded.

The applicant sought entitlement to a treatment plan for occupational therapy services following a motor vehicle accident.

The applicant failed to file submissions for the written hearing and had not participated in the matter since her counsel withdrew.

The Licence Appeal Tribunal found that the applicant had abandoned her application.

Alternatively, the Tribunal found that the applicant failed to prove entitlement to the treatment plan on the merits.

The application was dismissed.

The applicant was involved in a motor vehicle accident and received statutory accident benefits.

The insurer sought repayment of benefits, alleging the applicant willfully misrepresented that another individual was in the vehicle.

The Tribunal found that the applicant did make a willful misrepresentation.

However, because the applicant's own benefits were not paid 'as a result of' this misrepresentation, the insurer was not entitled to repayment under sections 52 or 53 of the Schedule.

The applicant was involved in a motor vehicle accident and received statutory accident benefits from the respondent insurer.

The insurer sought repayment of $3,500, alleging the applicant willfully misrepresented that a friend was in the vehicle during the accident.

The Tribunal found that the applicant did make a willful misrepresentation regarding the passenger.

However, the Tribunal held that the insurer was not entitled to repayment because the applicant's own benefits were not paid 'as a result of' the misrepresentation, as required by sections 52 and 53 of the Schedule.

The applicant sought statutory accident benefits after sustaining injuries during an altercation that began when he was sitting in his running rental vehicle.

The respondent denied the claim on the basis that the incident was an assault, not an 'accident' under the Statutory Accident Benefits Schedule.

The Tribunal found that the dominant feature of the incident was an unprovoked assault, which constituted an intervening act that broke the chain of causation.

The application was dismissed as the incident did not meet the definition of an accident.

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits.

The respondent insurer deemed the injuries to fall within the Minor Injury Guideline (MIG), capping benefits at $3,500.

The applicant argued he should be removed from the MIG due to pre-existing conditions, chronic pain, and psychological impairment.

The Tribunal found insufficient evidence of a pre-existing condition preventing maximal recovery, and no persuasive proof of chronic pain or psychological impairment.

The Tribunal concluded the applicant's injuries were predominantly minor and subject to the MIG cap.

As the cap was exhausted, the claims for further benefits and interest were dismissed.

The appellants appealed a summary judgment dismissing their negligence claim arising from a personal injury sustained during a fitness class at the respondent's facility.

The plaintiff stepped on a round dumbbell and fell.

The motion judge found that the respondents were not negligent, that the round dumbbell did not pose an unusual hazard, and that the risk of a round dumbbell rolling was obvious.

The motion judge also rejected the appellants' argument regarding a duty to warn.

The Court of Appeal upheld the summary judgment and dismissed the appeal.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent insurer denied several treatment plans for chiropractic and massage services on the basis that the applicant's injuries fell within the Minor Injury Guidelines (MIG).

The applicant argued that chronic pain and pre-existing conditions removed her from the MIG.

The Tribunal found that the applicant failed to establish functional impairment from chronic pain, noting inconsistencies in her self-reported symptoms and a lack of supporting employment records.

Furthermore, the applicant's pre-existing conditions were not disclosed to assessors and did not prevent maximal recovery within the MIG.

The Tribunal concluded the injuries were minor, dismissing the claims for treatment plans and interest.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied his claim for statutory accident benefits.

He argued the Tribunal made a significant error of fact and violated procedural fairness by failing to explicitly refer to or consider certain medical evidence submitted prior to the hearing.

The Executive Chair dismissed the request, finding that the Tribunal is not required to explicitly refer to every piece of evidence in its reasons, and that the applicant failed to demonstrate how the omitted documents were relevant to the benefits at issue.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision, including attendant care, medical benefits for orthotics and chiropractic treatment, costs of examinations, and medication expenses.

The Licence Appeal Tribunal dismissed all claims, finding that the applicant failed to prove attendant care expenses were incurred and that the proposed medical treatments and assessments were neither reasonable nor necessary given the applicant's pre-existing conditions and ability to perform self-care.

The respondent's request for costs due to the applicant's disregard of page limits was also denied.