51 total
Catastrophic impairment claim denied due to failure to establish marked psychological impairments beyond pre-existing conditions.
The applicant sought statutory accident benefits following a 2018 motor vehicle accident, claiming catastrophic impairment due to psychological injuries, non-earner benefits, treatment plans, and education expenses.
The Licence Appeal Tribunal found the applicant was not catastrophically impaired, preferring the respondent's psychiatric assessment which properly accounted for her significant pre-existing mental health conditions and post-accident stressors.
Claims for non-earner benefits and treatment plans were dismissed as the applicant failed to prove a complete inability to carry on a normal life or the reasonableness and necessity of the plans.
The Tribunal granted the claim for education expenses, finding the applicant was unable to continue her college program due to the accident.
Applicant barred from claiming non-earner benefits for failing to submit disability certificate within 104 weeks.
The applicant sought a non-earner benefit after her daughter was involved in a motor vehicle accident.
The respondent raised a preliminary issue that the applicant was statute-barred from proceeding with her claim because she failed to submit a disability certificate (OCF-3) within 104 weeks post-accident.
The Tribunal found that the language in section 36 of the Statutory Accident Benefits Schedule is compulsory and bars an applicant from pursuing a claim if the OCF-3 is submitted after the 104-week eligibility period.
The applicant was therefore barred from proceeding with her claim.
The respondent's request for costs was denied.
Application for non-earner benefits dismissed as statute-barred; 2013 denial notice without medical reasons was valid.
The applicant sought a non-earner benefit following a 2011 motor vehicle accident.
The respondent denied the benefit in November 2013 based on an updated disability certificate completed by the applicant's treating occupational therapist, which indicated she no longer suffered a complete inability to carry on a normal life.
The applicant applied to the Tribunal in 2022, arguing the 2013 denial was invalid for failing to provide medical reasons under section 37(4) of the Schedule.
Applying Varriano, the Tribunal held the denial was valid as it relied on a non-medical ground (the disability certificate), triggering the two-year limitation period.
The application was dismissed as statute-barred.
Appeal of dismissed simplified procedure action regarding a vehicle purchase dismissed for failure to prove damages.
The appellant brought a simplified procedure action against Kia Canada Inc. related to his purchase of a Kia Sorento in 2016.
The action was dismissed at trial, with the trial judge finding no breach of contract or the Sale of Goods Act, and that the appellant failed to prove compensable damages.
The Court of Appeal dismissed the appeal, finding no palpable and overriding error in the trial judge's factual findings or credibility assessments.
The court agreed that the appellant failed to prove compensable damages, noting his lost wages claim contradicted his declared income and he failed to lead evidence regarding any loss on the sale of the vehicle.
Accident benefits claim dismissed; non-earner benefits statute-barred and catastrophic impairment not established.
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.
Applicant designated catastrophically impaired due to accident-related psychological impairments; claims for travel expenses dismissed.
The applicant sought a determination of catastrophic impairment (CAT) under criterion 8 of the Statutory Accident Benefits Schedule following a motor vehicle accident.
The respondent denied the CAT designation, arguing the applicant's impairments were caused by pre-existing conditions and prior accidents.
The Tribunal applied the "but for" test and found the accident caused the applicant's psychological impairments, including somatic symptom disorder.
The Tribunal concluded the applicant suffered a marked impairment in activities of daily living, concentration, persistence and pace, and adaptation, thereby meeting the CAT threshold.
However, the applicant's claims for travel expenses for his daughter's flight and out-of-town CAT assessments were dismissed for lack of evidence establishing they were reasonable and necessary.
The claim for an award under s. 10 of Regulation 664 was also dismissed.
The court adjourned a settlement enforcement motion to investigate the self-represented plaintiff's mental capacity.
This motion sought to enforce two settlements (tort and accident benefits) totaling $2 million, which the plaintiff, Paul-Robert Hipkiss, refused to finalize by signing releases.
The plaintiff asserted the releases were unconstitutional restrictions on his freedom of speech.
The court expressed significant concerns regarding the plaintiff's mental capacity to make decisions in his best interests, noting his unrepresented status despite having a lawyer of record (QTMG LLP) whose interests appeared to conflict with his own.
The motion was adjourned, and the Public Guardian and Trustee was directed to investigate the plaintiff's capacity to manage property due to the serious adverse effects of his refusal to sign, including lack of access to settlement funds and ongoing accident benefits.
Application for catastrophic impairment and accident benefits dismissed due to lack of causation and pre-existing conditions.
The applicant sought statutory accident benefits following a 2019 motor vehicle accident, claiming catastrophic impairment due to a mental and behavioural disorder, along with attendant care, home modifications, and other medical benefits.
The Licence Appeal Tribunal found the applicant was not a credible witness and failed to establish that her impairments were caused by the accident, noting significant pre-existing physical and psychological conditions.
The Tribunal concluded the applicant did not meet the criteria for catastrophic impairment and dismissed all claims for disputed benefits, finding them either not reasonable and necessary, duplicative, or unrelated to the accident.
Application for accident benefits dismissed; spilled coffee in drive-thru not an accident due to intervening act.
The applicant sought statutory accident benefits after spilling hot coffee on his lap while in his vehicle at a drive-thru.
The respondent denied the claim, arguing the incident did not meet the definition of an 'accident' under section 3(1) of the Schedule and that the application was submitted late.
The Tribunal found that while the purpose test was met, the causation test failed because the improperly secured coffee cup lid was an intervening act that directly caused the injuries, breaking the chain of causation from the use of the vehicle.
Furthermore, the Tribunal held that the applicant was barred from proceeding because he failed to notify the respondent within the prescribed timelines and did not provide a reasonable explanation for the delay.
The application was dismissed.
Accident benefits largely denied due to unreliable self-report and pre-existing conditions; minor treatment plans approved.
The applicant, who has pre-existing cerebral palsy, sought various statutory accident benefits following a motor vehicle accident, including $6,000 per month for attendant care, $1,000,000 for home modifications, and multiple treatment plans.
The Tribunal found the applicant's self-report to be unreliable and preferred the evidence of the respondent's assessors, concluding that the accident caused only soft tissue injuries and an adjustment disorder, not the severe physical and cognitive decline claimed.
The Tribunal denied the claims for attendant care, home modifications, and most treatment plans, but approved psychological treatment and aquatherapy as reasonable and necessary.
Claims for interest on the approved plans were granted, but the request for a special award was dismissed.
Judicial review of WSIAT decision barring right to sue dismissed as reasonable.
The applicants sought judicial review of a Workplace Safety and Insurance Appeals Tribunal decision that precluded them from suing the respondent for personal injuries sustained by the applicant at her workplace.
The Tribunal found that both the applicant's employer and the respondent were Schedule 1 employers under the Workplace Safety and Insurance Act, 1997, and that the applicant was injured in the course of her employment while returning from a smoke break.
The Divisional Court dismissed the application, finding the Tribunal's decision was reasonable, well-reasoned, and consistent with the evidence, the law, and Board policies.
Requests for reconsideration of catastrophic impairment finding and costs award dismissed.
The applicant and respondent both sought reconsideration of a Licence Appeal Tribunal decision that found the applicant was not catastrophically impaired and awarded the applicant $2,000 in costs.
The applicant argued the Tribunal erred in its assessment of her activities of daily living and sought to introduce new evidence regarding her relationship breakdown.
The respondent argued the Tribunal erred in awarding costs based on its counsel's conduct.
The Vice-Chair dismissed both requests, finding no errors of law or fact in the original decision and concluding the new evidence would not have affected the result.
Plaintiff awarded $64,000 in partial indemnity costs after successful simplified procedure wrongful dismissal action.
Following a successful wrongful dismissal action under the simplified procedure, the plaintiff sought costs of over $100,000 on a substantial indemnity basis.
The defendants argued the claimed costs were disproportionate to the $98,576 damages awarded and the simplified procedure limits.
The court found the plaintiff's counsel's hours and rates unreasonable for a straightforward wrongful dismissal action.
Applying the principle of proportionality, the court awarded the plaintiff partial indemnity costs fixed at $55,000 for fees and $9,000 for disbursements, plus HST.
Catastrophic impairment claim denied; applicant's mental and behavioural impairments did not reach marked level.
The applicant sought a determination that she sustained a catastrophic impairment (CAT) due to a mental or behavioural disorder following a 2017 motor vehicle accident, which she claimed aggravated pre-existing concussion symptoms from a 2014 work incident.
The Tribunal found that while the applicant suffers from somatic symptom disorder and functional limitations, her impairments in activities of daily living do not rise to the level of a marked (Class 4) impairment under the AMA Guides.
Consequently, she did not meet the criteria for CAT status.
As her non-CAT policy limits were exhausted, her claims for various medical and attendant care benefits were dismissed as moot.
The Tribunal awarded the applicant $2,000 in costs due to the respondent's excessive and unnecessary objections during the hearing.
Catastrophic impairment claim barred as abuse of process; attendant care claim stayed pending unconditional assessment attendance.
The applicant sought a catastrophic impairment designation and attendant care benefits following a motor vehicle accident.
The respondent brought a preliminary motion arguing the catastrophic impairment claim was barred by abuse of process, as a previous Tribunal decision had rejected the applicant's evidence as unreliable.
The respondent also argued the attendant care claim was barred because the applicant failed to attend an insurer's examination by insisting her treating occupational therapist be present.
The Tribunal granted the respondent's motion, barring the catastrophic impairment claim to prevent relitigation of factual findings, and staying the attendant care claim until the applicant attends the examination without preconditions.
Summary judgment denied; novel claim for psychological injury by mother who heard accident aftermath over telephone requires trial.
The defendants brought a motion for summary judgment to dismiss the plaintiff's claim for psychological injuries.
The plaintiff, who was not present at the motor vehicle accident, suffered psychological trauma after hearing the immediate aftermath of the collision over the telephone while speaking to her injured daughter.
The court dismissed the motion, finding that whether a duty of care extends to an 'auditory witness' via telephone is a novel issue requiring a full trial.
The court also found genuine issues for trial regarding the discoverability of the claim under the Limitations Act and whether the injuries met the statutory threshold under the Insurance Act.
Leave granted to amend claim for $100 million in punitive damages; request for reference on valuation denied.
The plaintiff sued her property insurer and broker after her home was destroyed in a fire.
She brought a motion to amend her statement of claim to increase her claim for punitive damages against the insurer to $100 million, and for directions to have a reference determine the value of the lost contents.
The court granted the amendment, finding that while the amount claimed was preposterous, it was not unmeritorious on its face and caused no prejudice not compensable by costs.
The court dismissed the request for a reference, holding that Rule 54.02(1) does not permit a reference without consent when a jury notice has been served, and that a reference would be inappropriate given the credibility issues involved in proving the loss.
Insured's election of New York benefits was valid; insurer not required to provide legal advice.
The applicant was involved in a motor vehicle accident in New York and elected to receive New York no-fault benefits.
She later applied to the Licence Appeal Tribunal for Ontario statutory accident benefits, arguing her initial election was invalid because the insurer failed to provide sufficient information under section 32 of the Schedule.
The Tribunal found the insurer complied with its obligations to provide appropriate forms and a written explanation of benefits, and was not required to provide legal advice on which jurisdiction to choose.
The election was deemed valid and binding, precluding the applicant from re-electing Ontario benefits.
Defendants awarded costs thrown away and pre-judgment interest suspended due to plaintiff-caused trial adjournment.
The defendants brought a motion seeking costs thrown away on a substantial indemnity basis for a late trial adjournment and an order suspending pre-judgment interest.
The trial was adjourned due to the plaintiff's counsel's failure to comply with timetable orders, including providing proper witness statements and an ever-changing witness list, which rendered the original four-week trial estimate unrealistic.
The court found the plaintiff and his counsel responsible for the adjournment, awarded the defendants $100,000 in costs thrown away on a partial indemnity basis, and suspended pre-judgment interest from the original trial date until the new trial date.
The court awarded $2,500 in costs for a straightforward venue transfer motion, rejecting the defendants' $12,000 claim as excessive.
This costs endorsement followed a successful motion by the defendants to transfer an action from Perth to Oshawa.
The court found the defendants' requested costs of over $12,000 to be excessive for a straightforward, in-writing motion within a Simplified Procedure action.
The court awarded all-inclusive costs of $2,500, payable by the plaintiff to the defendants.