Meral Kesebi

The applicant sought statutory accident benefits after being struck by a skid steer Caterpillar snowplow while walking in a parking lot.

The respondent denied benefits on the basis that the incident was not an 'accident' under section 3(1) of the Statutory Accident Benefits Schedule.

The Tribunal applied the Adams test and found that the snowplow was not an 'automobile' in ordinary parlance, under any insurance policy, or under any enlarged statutory definition, as it qualified as an exempt 'road-building machine' under the Highway Traffic Act.

The application was dismissed.

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

The respondent denied several treatment plans, arguing that the $65,000 non-catastrophic monetary limit had been exhausted.

The Tribunal found that the respondent failed to prove the limit was exhausted and that several of its denial notices were non-compliant with s. 38(8) of the Schedule for failing to clearly state that the limit was fully reached at the time of denial.

Consequently, the Tribunal ordered payment for several treatment plans subject to the non-catastrophic limit, while dismissing claims for other plans that were either duplicative or not reasonable and necessary.

The applicant's request for a special award was denied.

The applicant sought various statutory accident benefits following a motor vehicle accident, including attendant care, chiropractic, psychological, and occupational therapy services, as well as the cost of a catastrophic impairment assessment.

The Licence Appeal Tribunal found that the insurer failed to provide timely notice of denial for one chiropractic treatment plan, rendering it payable for the period of delay under s. 38(11) of the Schedule.

The Tribunal also approved an in-home assessment.

However, the Tribunal dismissed the claims for attendant care benefits and the remaining treatment plans, finding the applicant failed to prove they were reasonable and necessary, largely preferring the objective findings of the insurer's examiners over the applicant's subjective complaints.

The claim for a special award under s. 10 of Regulation 664 was also dismissed.

The applicant sought various statutory accident benefits following a motor vehicle accident, including treatment plans for social rehabilitation counselling, occupational therapy, and vocational training, as well as an expense for a replacement iPhone.

The Tribunal first determined that the applicant's claim for an occupational therapy treatment plan was not statute-barred, as the limitation period was suspended during the COVID-19 pandemic.

However, the Tribunal dismissed all substantive claims, finding that the applicant failed to establish on a balance of probabilities that the disputed treatment plans and expenses were reasonable and necessary or payable under the Schedule.

The applicant sought statutory accident benefits after slipping and falling on ice while opening the trunk of a vehicle.

The respondent denied benefits, arguing the incident was a slip and fall on ice and not an 'accident' under the Schedule.

The Tribunal applied the purpose and causation tests, finding that the mechanics of opening the trunk created a significant fall risk that was the dominant feature of the incident.

The Tribunal concluded the incident met the definition of an 'accident' under s. 3(1) of the Schedule.

The applicant, who was a minor at the time of the motor vehicle accident, sought a non-earner benefit and medical/rehabilitation benefits.

The insurer denied the benefits, and the applicant filed an application with the Licence Appeal Tribunal more than two years after the denials.

The applicant argued that the limitation period for the non-earner benefit should only commence upon turning 18, relying on the rule of discoverability.

The Tribunal held that the limitation period is triggered by the insurer's refusal to pay, regardless of the applicant's age.

The Tribunal declined to extend the limitation period under section 7 of the Licence Appeal Tribunal Act, finding no bona fide intention to appeal within the time limit, an excessive and unexplained delay, prejudice to the respondent, and a lack of merit.

The application was dismissed as statute-barred.

Oscar Sun, a minor, suffered catastrophic injuries after being hit by a car driven by Sergio Ferreira after exiting a TTC bus.

The plaintiffs (Sun, Chen, Sun) sued Ferreira, TTC, and the City of Toronto.

Ferreira also brought a third-party claim against TTC and the City.

The City, TTC, and Donald Carter brought two motions for summary judgment to dismiss the plaintiffs' action against them and Ferreira's third-party claim, arguing the claims were statute-barred by the Limitations Act, 2002.

The court dismissed both motions, finding a genuine issue requiring a trial regarding the discoverability of the claims and whether it was appropriate to commence legal action earlier, particularly concerning the alleged negligent design of the bus stop and crosswalks.

The court also noted concerns about partial summary judgment.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment due to mental and behavioural disorders, non-earner benefits, and attendant care benefits.

The arbitrator dismissed all claims, finding that the applicant was malingering.

The arbitrator rejected the applicant's expert evidence due to flawed methodology and inconsistencies, preferring the insurer's expert and surveillance evidence which showed the applicant engaging in normal daily activities.

The arbitrator also found the accident involved minor forces comparable to everyday activities, making the claimed severe impairments implausible.

The applicants sought judicial review of a FSCO Director's Delegate decision that upheld an arbitrator's exclusion of the applicant's documents and witnesses due to late service, and ordered costs personally against the applicant's lawyers.

The Divisional Court dismissed the application, finding no denial of procedural fairness in the refusal to allow an affidavit explaining the delay or in the exclusion of non-expert witnesses.

The court also held that the order for costs against the lawyers personally was reasonable given the blatant disregard of the procedural rules.

This was a costs endorsement following a venue transfer motion in a slip and fall action arising from an incident at a rental cabin near North Bay.

The plaintiff had unsuccessfully sought to transfer the action to Welland, while the defendants successfully obtained a transfer to North Bay.

Applying s. 131(1) of the Courts of Justice Act and Rule 57.01(1) of the Rules of Civil Procedure, the court held that costs should follow the event but reduced the defendants' requested amounts because the claims were excessive, involved duplication of preparation, and were disproportionate to the complexity of the matter.

The plaintiff was ordered to pay each defendant $1,200 inclusive of disbursements and HST.