Michael L. Bennett

The applicant sought income replacement benefits following a motor vehicle accident but failed to submit a Disability Certificate (OCF-3) within 30 days of receiving the application package, as required by the Statutory Accident Benefits Schedule.

The applicant argued that the limitation period should be extended due to the COVID-19 pandemic under O. Reg. 73/20.

The Tribunal found that the limitation period expired well before the pandemic began and that the applicant failed to provide a reasonable explanation for the delay.

The Tribunal also held that it lacks jurisdiction to grant relief from forfeiture under section 129 of the Insurance Act.

The application was dismissed as statute-barred.

The applicant sought statutory accident benefits for psychological treatment to address post-traumatic stress disorder following a motor vehicle accident.

The respondent partially denied two treatment plans, arguing that the proposed length and number of sessions were excessive and that a local treatment provider should be used to reduce travel expenses.

The Tribunal found that the applicant's treating psychologist was the preferred option due to his extensive experience and established patient-psychologist relationship, and that surveillance evidence did not undermine the applicant's psychological impairments.

The Tribunal concluded that the treatment plans were partially reasonable and necessary, awarding portions of the claimed amounts along with interest on overdue payments.

The applicant, an 80-year-old pedestrian struck by a vehicle, sustained physical injuries and a traumatic brain injury, resulting in catastrophic impairment.

She sought a housing modification benefit of $158,476.89.

The respondent insurer partially approved $24,282.00 based on its own assessments, arguing the applicant's proposed modifications were excessive.

The Tribunal found the applicant's proposal largely unrealistic and disproportionate, preferring the respondent's more modest proposal.

However, the Tribunal also approved the applicant's request for an accessible kitchen package and closet organizers as reasonable and necessary to accommodate her accident-related impairments.

The insurer sought reconsideration of a preliminary issue order that precluded the insured from proceeding with a catastrophic impairment hearing until the insurer conducted two insurer examinations (IEs).

The order included a term allowing the IEs to proceed by paper review if the parties could not agree on conditions for in-person assessments.

The insurer argued this term violated natural justice by placing it at a disadvantage.

The Tribunal denied the reconsideration, finding that the original adjudicator properly balanced the insurer's right to an IE against the potential harm to the insured, and that paper reviews are expressly permitted under the Schedule.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the insurer, claiming he sustained a catastrophic impairment due to severe psychological and physical injuries.

The insurer denied the claims, arguing the applicant was malingering and not significantly disabled.

The arbitrator found the applicant credible and concluded he suffered a catastrophic impairment under s. 2(1.2)(g) of the Schedule, experiencing marked impairment in activities of daily living and concentration, persistence, and pace.

The arbitrator awarded income replacement benefits, attendant care benefits at $6,000 per month, and an occupational therapy treatment plan.

Housekeeping benefits were denied due to insufficient evidence of the pre-accident baseline.

A special award of $5,000 was ordered against the insurer for unreasonably delaying payment for the applicant's psychiatric medications.

The plaintiffs brought a negligence action against a municipality arising from a single‑vehicle collision on a rural road curve that caused catastrophic injuries to a young driver.

The court considered whether the municipality breached its duty under s. 44 of the Municipal Act to keep the roadway in a reasonable state of repair, focusing primarily on inadequate warning signage and the absence of an advisory speed sign for a sharp curve.

Expert evidence established that proper signage, including a 40 km/h advisory speed tab and additional warning devices required by the Ontario Traffic Manual, should have been installed.

The municipality had not conducted any evaluation of the signage following amalgamation and allowed substandard signage to remain in place for years.

The court found the municipality liable for failing to maintain the road in a reasonable state of repair, but also held the driver contributorily negligent for failing to sufficiently reduce speed in snowy conditions.

The applicant's counsel brought a motion to withdraw as solicitors of record due to a breakdown in the solicitor-client relationship.

The insurer took no position on the withdrawal but requested urgent notice regarding whether the upcoming hearing would proceed.

The applicant consented to the withdrawal.

The arbitrator granted the motion to withdraw without terms and adjourned the hearing on consent of the parties.

The appellant insurer appealed a motion judge's conclusion regarding waiver.

The Court of Appeal dismissed the appeal, finding no error in the motion judge's conclusion, which turned narrowly on the absence of a non-waiver agreement and the specific wording and timing of an August 23, 2006 letter.

The Court noted this decision does not pronounce on the general effect of a reservation of rights letter.