Melinda Jane Baxter

The applicant requested a reconsideration of a preliminary issue decision which found she was barred from proceeding with her accident benefits claim due to a seven-month delay in notifying the insurer.

The applicant argued the Tribunal failed to meaningfully apply the consumer protection mandate of the Schedule and overly focused on the length of delay and lack of medical documentation.

The Tribunal dismissed the request, finding the applicant was attempting to re-litigate her case and had not established any error of law or fact that would warrant a reconsideration under Rule 18.2(b).

The applicant sought statutory accident benefits after being attacked by a dog that leaped from a parked vehicle.

The insurer denied the claim on the basis that the incident was not an 'accident' under the Schedule and that the applicant failed to provide timely notice.

The Tribunal found that the incident did not meet the purpose or causation tests for an accident, as the dog attack was an intervening act and the dominant feature of the injuries.

Furthermore, the applicant failed to provide a reasonable explanation for her seven-month delay in notifying the insurer.

The application was dismissed.

The appellant sought judicial review of decisions from the Human Rights Tribunal of Ontario (HRTO) and the Licence Appeal Tribunal (LAT).

On consent, the Divisional Court quashed the HRTO decisions and remitted the matter for further adjudication without specific directions.

The Court also quashed the LAT decisions and remitted the matter for a new hearing before a different adjudicator, with reasons to follow.

The applicant was involved in a motor vehicle accident while driving his employer's vehicle and sought statutory accident benefits.

The respondent insurer argued the applicant was barred from proceeding because he failed to notify them within seven days and failed to submit his application within 30 days.

The Tribunal found the applicant had a reasonable explanation for the delay, as he reasonably believed his employer had notified the insurer, and the insurer never provided the required application forms to trigger the 30-day timeline.

The applicant was permitted to proceed with his claim.

The applicant was injured in a bicycle accident in April 2023 but did not submit an Application for Accident Benefits (OCF-1) to the respondent insurer until January 2025.

The respondent argued the applicant was barred from proceeding due to the delay.

The Tribunal found that the applicant failed to comply with the seven-day notice requirement under section 32 of the Schedule and did not provide a reasonable explanation for the delay.

Ignorance of the law and a subjective belief that injuries would resolve through OHIP care were not accepted as reasonable explanations.

The application was dismissed as statute-barred.

The applicant/appellant commenced a second application to the Licence Appeal Tribunal (LAT) seeking damages and declaratory relief against her insurer and various non-insurer parties for alleged tortious conduct related to her statutory accident benefits (SABS) claims.

The LAT dismissed the application for lack of jurisdiction, noting it had no authority to award damages or make orders against non-insurers.

The applicant/appellant appealed to the Divisional Court.

The Court issued a notice under Rule 2.1.01 of the Rules of Civil Procedure and subsequently dismissed the proceedings as frivolous, vexatious, and an abuse of process, finding that the LAT lacks statutory jurisdiction to grant the requested relief and that the proceedings were an impermissible collateral attack on a prior final LAT decision.

The applicant sought a determination of catastrophic impairment and entitlement to various medical, rehabilitation, and transportation benefits following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant did not sustain a catastrophic impairment under either Criterion 7 (55% Whole Person Impairment) or Criterion 8 (mental or behavioural disorder), preferring the respondent's medical evidence which indicated lower impairment ratings.

However, the Tribunal granted the applicant's claims for a psychological treatment plan and an occupational therapy assessment, finding them reasonable and necessary.

The claims for transportation expenses were dismissed for lack of evidence.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that dismissed her application without a hearing.

The applicant had sought damages for torts, including intimidation, against the insurer and other named respondents.

The Vice-Chair dismissed the reconsideration request, finding no error of law or fact in the initial determination that the Tribunal lacks jurisdiction to award common law damages or punitive damages.

The Tribunal reaffirmed that its remedial powers are limited to those granted by statute, such as deeming benefits incurred or making special awards, and do not extend to tort damages.

The applicant was injured in a bicycle-automobile collision and suffered a traumatic brain injury.

She applied for a non-earner benefit but the insurer denied payment for the period before she submitted her disability certificate (OCF-3), relying on s. 36(3) of the Statutory Accident Benefits Schedule.

The applicant argued that s. 36(3) should be interpreted to exempt incapable applicants, or alternatively, that it violates the Charter and the Human Rights Code.

The Tribunal rejected the applicant's interpretation, finding the language of s. 36(3) clear and mandatory.

The Tribunal also found the applicant failed to establish a constitutional or Code violation.

The application was dismissed.

The applicant sought statutory accident benefits following a 2010 motor vehicle accident.

After multiple adjournments and failures to comply with Tribunal orders, the applicant failed to attend the scheduled virtual hearing despite receiving proper notice.

The Tribunal proceeded in absentia and dismissed the application, as the applicant presented no evidence and failed to meet her burden of proof.

The Tribunal awarded $1,000 in costs to the respondent due to the applicant's serious misconduct in disregarding the Tribunal's process.

The applicant sought statutory accident benefits following a motor vehicle accident, including a determination of catastrophic impairment and non-earner benefits.

The Licence Appeal Tribunal found the claim for non-earner benefits was statute-barred due to the applicant's failure to submit an OCF-3 within 104 weeks of the accident.

The Tribunal also concluded the applicant did not sustain a catastrophic impairment, preferring the respondent's psychiatric assessment over the applicant's, noting the applicant's assessor failed to consider a pre-existing ADHD diagnosis.

Claims for various treatment plans and expenses were dismissed for lack of evidence establishing reasonableness and necessity.

The applicant requested a reconsideration of a previous Motion Order that dismissed her request for costs.

The Tribunal found that it had made an error of procedural fairness by failing to consider the applicant's cost submissions in the original order.

The Tribunal granted the reconsideration request to review the submissions.

However, upon reviewing the submissions, the Tribunal found that the respondent's behaviour did not meet the high bar required for a cost award under Rule 19.1.

The applicant's request for $2,000 in costs was denied.

The applicant sought statutory accident benefits for psychological services, chiropractic services, and a driver anxiety assessment following a motor vehicle accident.

The insurer denied the benefits.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to establish on a balance of probabilities that the requested treatments and assessment were reasonable and necessary as a result of the accident.

The Tribunal noted the applicant's pre-existing psychological conditions and found insufficient evidence linking her current symptoms to the accident.

Claims for interest and an award under Regulation 664 were also dismissed.

The applicant sought various medical and rehabilitation benefits following a 2012 motor vehicle accident.

The Licence Appeal Tribunal denied claims for PRP injections, a neuropsychological assessment, an in-home assessment balance, and assistive devices, finding them either not reasonable and necessary or statute-barred for failure to attend an insurer's examination.

The Tribunal partially approved a treatment plan for psychological counselling, awarding $3,118.77 plus interest, after finding the proposed costs for transportation, brokerage, and documentation to be gratuitous and inflated.

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

The respondent denied treatment plans for chiropractic/massage therapy, a psychological assessment, and psychological treatment.

The Tribunal found the chiropractic and massage therapy plan was not reasonable and necessary, preferring the respondent's physiatry assessment which recommended a home exercise program.

However, the Tribunal found the psychological assessment and treatment plans were reasonable and necessary, concluding that the accident exacerbated the applicant's pre-existing anxiety and depression.

The Tribunal rejected the respondent's psychiatric assessment because it failed to address the applicant's in-vehicle anxiety and lacked objective testing.

The applicant's claim for a special award under Ontario Regulation 664 was dismissed as the respondent had relied on its own medical assessments.

The defendant brought a consent motion in writing to adjourn a trial scheduled for October 5, 2020, arising from a 2012 motor vehicle accident.

The parties sought the adjournment because they had not held a pretrial conference and claimed scheduling conflicts prevented them from attending a pretrial date offered by the court in September.

The court dismissed the motion, noting that trial dates in Toronto are only adjourned in extenuating circumstances.

The court found the motion materials deficient and held that counsel's preference to schedule a pretrial after the trial date was not a compelling reason to adjourn a trial that had been fixed for over a year.

The applicant was injured in a motor vehicle accident in 2002 when he was six years old.

He did not apply for accident benefits until 2016, after reaching the age of majority.

The respondent insurer denied the application on the basis that it was statute-barred due to delay.

The applicant argued that a tort action letter sent to the insurer in 2014 constituted sufficient notice and that he had a reasonable explanation for the delay.

The Tribunal found that the tort action letter provided sufficient notice and that the insurer failed to meet its obligations to provide the applicant with the necessary forms.

The Tribunal also found that the applicant had a reasonable explanation for the delay, given his age at the time of the accident and his parents' status as recent immigrants without insurance.

The applicant was permitted to proceed with his claim.

The insurer requested reconsideration of a decision awarding the applicant non-earner benefits, a psychological assessment, and a special award.

The adjudicator admitted late correspondence from the insurer as new evidence.

Based on this new evidence, the adjudicator varied the start date for the non-earner benefits from September 22, 2016, to October 25, 2016, and rescinded the special award regarding the non-earner benefits, finding the insurer's conduct was not unreasonable.

The adjudicator dismissed the insurer's arguments regarding the psychological assessment, finding no error in giving little weight to an insurer's examination report that was not in existence when the treatment plan was denied.

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

The insurer denied three treatment plans for psychological and orthopaedic assessments and counselling.

The applicant argued the insurer failed to comply with the strict notice requirements under s. 38(8) of the Statutory Accident Benefits Schedule by providing boilerplate reasons that lacked specific details about her medical condition.

The Tribunal agreed, finding the insurer's denial notices deficient.

Consequently, under s. 38(11), the insurer was ordered to pay for the disputed treatment plans.

The Tribunal also awarded the applicant a 20% lump sum under Regulation 664 for the insurer's unreasonable withholding of benefits regarding two of the plans, noting the insurer's failure to respond to correspondence and clarify its denials.

The applicant, who was catastrophically injured in a motor vehicle accident, applied for attendant care benefits in the amount of $3,790.38 per month.

The respondent partially approved the claim in the amount of $2,331.07 per month.

The respondent raised a preliminary issue that the Tribunal lacked jurisdiction because the applicant was not incurring expenses above the approved amount.

The Tribunal dismissed the preliminary issue, finding that a dispute exists over the quantum of the benefit regardless of whether it has been incurred.

On the merits, the Tribunal found the applicant entitled to $2,997.30 per month in attendant care benefits, concluding that he requires 8 hours of attendant care daily.