Meredith A. Harper

The applicant sought statutory accident benefits following a 2021 motor vehicle accident.

The Tribunal found the applicant sustained a catastrophic impairment under Criterion 8 due to marked impairments in all four areas of function (activities of daily living, social functioning, concentration, persistence and pace, and adaptation) stemming from accident-related mental and behavioural disorders, including somatic symptom disorder and exacerbated PTSD.

However, the Tribunal dismissed the claims for a non-earner benefit, attendant care benefits, and various treatment plans, finding the applicant did not suffer a complete inability to carry on a normal life and failed to prove the treatment plans were reasonable and necessary.

The defendant brought a pre-trial motion to strike the plaintiffs' claim for non-pecuniary general damages and healthcare expenses arising from a motor vehicle accident, on the basis that the plaintiffs failed to adduce the evidence required by s. 4.3(1) to (5) of O. Reg. 461/96 to establish the statutory threshold of permanent serious impairment.

The court found that no single medical report, nor the totality of the medical records proffered, satisfied the regulation's requirements for qualified physician evidence addressing the nature, permanence, and importance of the alleged impairment.

The motion was granted and the claims for non-pecuniary general damages and healthcare expenses were struck.

The applicant sought entitlement to various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The Tribunal drew an adverse inference against the applicant for failing to produce clinical notes and records as ordered.

The Tribunal denied the majority of the treatment plans, finding insufficient medical evidence to support them and preferring the respondent's independent medical examination over the applicant's chronic pain assessment.

The Tribunal awarded $300.00 for interpretation services related to a chronic pain assessment, as the applicant is deaf and mute, but denied all claims for transportation expenses due to the 50-kilometre deductible.

Claims for a special award were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits, physiotherapy, psychological services, and a psychological assessment.

The respondent denied the benefits.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove the treatment plans were reasonable and necessary.

The Tribunal also found the applicant did not suffer a complete inability to carry on a normal life, relying on independent medical examinations indicating the applicant continued to work and attend school without significant functional limitations.

Claims for interest and an award for unreasonable delay were also dismissed.

The respondent insurer requested a reconsideration of a preliminary issue decision which found that the applicant was an 'insured person' under the Schedule because she and the catastrophically injured person were sisters.

The respondent argued the Tribunal erred in fact and law, asserting the evidence supported a finding that they were cousins.

The Tribunal dismissed the request, finding that the respondent improperly attempted to re-weigh evidence and raise new case law that was not presented at the initial hearing.

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

The respondent insurer split the determination of her injuries, subjecting her physical injuries to the Minor Injury Guideline (MIG) limits while accepting her psychological injuries were non-minor.

The applicant applied to the Licence Appeal Tribunal.

At the case conference, the respondent agreed to pay the disputed benefits.

The Tribunal held a written hearing to determine if the applicant was entitled to an award under section 10 of Regulation 664.

The Tribunal found the respondent's position to split the determination was contrary to settled law and constituted unreasonable withholding of benefits.

The applicant was awarded $3,194.41, representing 50% of the amounts withheld based on the split determination.

The applicant sought entitlement to a non-earner benefit and two treatment plans for medical and occupational therapy services following a motor vehicle accident.

The Tribunal found that while the applicant sustained a concussion in the accident, she failed to demonstrate a complete inability to carry on a normal life, as evidence showed she continued her university studies with high grades and accommodations.

The claims for the treatment plans were dismissed because the applicant failed to produce the OCF-18s in evidence or make submissions on their specific goals and modalities, making it impossible to assess their reasonableness and necessity.

The application was dismissed in its entirety.

The applicant sought a non-earner benefit, interest, and an award following a motor vehicle accident.

The Tribunal found that the applicant failed to prove on a balance of probabilities that she suffered a complete inability to carry on a normal life.

The applicant did not provide sufficient evidence of her pre-accident activities or their frequency to allow for a comparison with her post-accident abilities.

The Tribunal preferred the respondent's psychological assessment over the applicant's evidence, noting inconsistencies in the applicant's social worker report.

The application was dismissed.

The applicant sought a non-earner benefit, interest, and an award following a motor vehicle accident.

The adjudicator found that the applicant failed to prove on a balance of probabilities that she suffered a complete inability to carry on a normal life, as she did not provide sufficient evidence of her pre- and post-accident activities to allow for a comparison under the Heath factors.

The adjudicator preferred the respondent's insurer examination reports over the applicant's psychological report, which contained several inconsistencies.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit (IRB) and numerous treatment plans.

The Tribunal held that the 'complete inability' test for IRBs applies 104 weeks after the accident, not after 104 weeks of cumulative disability, and found the applicant did not meet this standard as she transitioned between similar factory jobs.

The Tribunal approved several treatment plans for chiropractic and occupational therapy services based on ongoing physical pain, as well as a later social work plan, but denied others lacking evidentiary support.

Claims for a section 10 award and costs were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, medical and rehabilitation benefits, and an award under s. 10 of Reg. 664.

The Tribunal found that the applicant failed to provide sufficient evidence to establish a complete inability to carry on a normal life for the non-earner benefit.

Furthermore, the applicant did not meet the evidentiary burden to prove that the proposed psychological, chiropractic, and dental treatments were reasonable and necessary.

The application was dismissed in its entirety.

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

The respondent denied benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's injuries fell outside the MIG due to significant accident-related psychological impairments, relying on the evidence of her treating psychiatrist.

The Tribunal approved one treatment plan for physiotherapy services but denied the remaining plans for physical treatment, devices, and various assessments, finding them not reasonable and necessary.

The applicant's claim for a non-earner benefit was dismissed as she failed to prove a complete inability to carry on a normal life.

The claim for a special award was also dismissed.

This endorsement addresses costs following a summary trial where the plaintiff's claim was dismissed.

The defendant, who successfully defended the action, sought costs up to the maximum allowed under simplified procedure rules ($84,750).

The plaintiff did not make submissions.

The court considered factors under Rule 57.01, noting the defendant's counsel incurred excessive hours due to travel and having two counsel, and characterized the defendant's litigation approach as "scorched earth" and disproportionate.

The court also found neither party made serious efforts to resolve the case economically.

Ultimately, the court exercised its discretion to award the defendant costs fixed at $45,000, inclusive of fees, disbursements, and HST, which was less than the maximum sought.

The plaintiff sued the defendant for damages arising from a car collision.

The court found the defendant negligent and that his negligence caused certain injuries to the plaintiff.

However, the plaintiff's injuries, primarily cervical and lumbar strain exacerbating pre-existing chronic pain, along with some generalized anxiety and headaches, were found not to meet the statutory threshold for recovery of general damages or health care expenses under the Insurance Act.

The court determined that the impairments were not permanent or serious enough to substantially interfere with most of the plaintiff's usual activities of daily living, especially considering her significant pre-existing health issues and inconsistent participation in recommended treatments.

Consequently, the defendant's threshold motion was granted, and the action was dismissed.

The applicant failed to appear for a scheduled four-day video conference hearing and served a notice of withdrawal shortly after the hearing was set to begin.

The respondent sought costs under Rule 19 of the Tribunal's Common Rules.

The Tribunal found the applicant's failure to provide timely notice of the withdrawal and failure to respond to communications to be unreasonable and disrespectful, causing an unnecessary expenditure of resources.

Costs of $400 were awarded to the respondent to deter future unreasonable conduct.

The appellant insurer appealed a Licence Appeal Tribunal decision finding that a binding settlement of tort and accident benefits claims was reached via email following mediation.

Shortly after the email exchange, the plaintiff was killed.

The insurer argued no settlement was reached because the plaintiff had not finalized the structure percentage or signed the settlement disclosure notice.

The Divisional Court dismissed the appeal, holding that the essential terms were agreed upon, the structure percentage was a default minimum, and the right to rescind under consumer protection legislation implies a settlement was already reached.

The applicant sought statutory accident benefits following a sideswipe motor vehicle collision, claiming entitlement to an income replacement benefit, various medical and rehabilitation treatment plans, and a special award.

The respondent denied the benefits on the basis that the applicant did not suffer a substantial inability to perform the essential tasks of her employment and that the proposed treatments were not reasonable or necessary.

The Tribunal dismissed the application in its entirety, preferring the evidence of the respondent's experts who found no objective pathology, noted significant self-limiting and non-credible behaviour on validity testing, and concluded the collision forces were insufficient to cause the alleged mild traumatic brain injury.

The claim for a special award was also dismissed as the respondent's adjusting was found to be reasonable.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for chiropractic treatment, physiotherapy, psychological services, and catastrophic impairment assessments.

The respondent insurer denied the benefits.

The Licence Appeal Tribunal found the chiropractic and physiotherapy treatment plans were reasonable and necessary to address the applicant's chronic pain, noting conflicting opinions among the insurer's own assessors.

However, the Tribunal denied the psychological services due to the applicant's failure to comply with a section 46.2 request for a statutory declaration.

The Tribunal also denied the balance of the catastrophic assessment fees because they exceeded the strict $2,000 statutory limit per assessment.

The claim for an award was dismissed.

This is an appeal from a trial judgment that found a third party, Dennis G. K. Chu, 50% responsible for injuries sustained by Tate Moran in a motor vehicle accident, requiring him to indemnify Ottavio Fabrizi for a settlement.

The trial judge determined that Chu's intentional tortious conduct (road rage) was a "but for" cause of Fabrizi running a red light and colliding with another vehicle.

Chu appealed, arguing errors in the application of the causation test, the failure to consider Fabrizi's negligence as an intervening act, and the misapplication of the "agony of the moment" doctrine.

The Court of Appeal dismissed the appeal, affirming that contribution and indemnity under the Negligence Act can apply where one tort is intentional and the other negligent.

The court upheld the trial judge's "but for" causation finding and clarified that the "agony of the moment" doctrine is a defence to the standard of care, not a causation issue, and is not available to the party who created the emergency.

The applicant sought reconsideration of a decision denying his claim for visitor expenses under the Statutory Accident Benefits Schedule.

The applicant argued that the adjudicator erred in law and acted outside his jurisdiction by relying on the Minor Injury Guideline to deny the claim.

The Tribunal dismissed the request for reconsideration, finding that the applicant was essentially asking to reweigh the evidence.

The Tribunal held that the applicant failed to establish at the first instance that the visitor expenses were reasonable and necessary as a result of impairments sustained in the accident.