Miguel Maruszki

The applicant sought approval for three treatment plans for chiropractic and massage therapy, and payment of the balance of a partially paid treatment plan, following a motor vehicle accident.

The insurer denied the plans on the basis that the applicant had reached maximum medical recovery.

The Licence Appeal Tribunal ordered the insurer to pay the outstanding balance on the partially paid invoices, finding that the clinical notes and records provided sufficient evidence that the services were rendered.

The Tribunal also approved the massage therapy portions of the denied plans for pain control, but denied the multiple body site therapy portions, accepting the insurer's medical examination evidence that the appellant had plateaued and the proposed therapy was not reasonable and necessary.

The applicants sought reconsideration of two Tribunal decisions that found their accident benefits claims were statute-barred.

The applicants argued the Tribunal erred in applying the four-part test for extending time under section 7 of the LAT Act.

The Vice-Chair found the Tribunal made significant errors of law and fact, particularly in attributing the delay caused by the Financial Services Commission of Ontario's backlog to the applicants, and in its assessment of prejudice to the respondent.

The requests for reconsideration were granted, and the time for filing the appeals was extended.

The applicant sought an extension of time under section 7 of the Licence Appeal Tribunal Act to commence a proceeding for statutory accident benefits after missing the two-year limitation period.

The applicant originally filed for mediation at FSCO but failed to proceed to the Tribunal in a timely manner after the mediation was deemed failed.

The Tribunal applied the four-part test for extending time and found the applicant provided no reasonable explanation for the delay.

Furthermore, the Tribunal found the respondent would be prejudiced by the delay.

The request for an extension of time was denied and the application was dismissed.

The applicant sought an extension of time under section 7 of the Licence Appeal Tribunal Act to commence a proceeding for statutory accident benefits after missing the two-year limitation period.

The applicant initially filed for mediation at FSCO but failed to re-file with the Tribunal in a timely manner after the mediation was deemed failed.

The adjudicator applied the four-part test for extending time and found no reasonable explanation for the delay, noting that the respondent would be prejudiced by the passage of time.

The request for an extension of time was denied and the application was dismissed.

The Executive Chair reconsidered two Tribunal decisions that found the applicants' claims for statutory accident benefits were statute-barred by the two-year limitation period.

The Executive Chair found that the Tribunal made a significant error of law by failing to consider whether to grant an extension of time under s. 7 of the Licence Appeal Tribunal Act, 1999.

A rehearing was ordered to determine whether an extension of time should be granted based on the four-factor test.

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

The applicant filed for mediation at FSCO, but the mediation did not take place and the file was closed.

The applicant subsequently filed an application with the Licence Appeal Tribunal after the transition of dispute resolution from FSCO to the Tribunal.

The Tribunal held that the application was statute-barred because it was filed beyond the two-year limitation period and outside the 90-day extension period following the closure of the FSCO mediation file.

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

The applicant filed for mediation at FSCO, but the mediation did not take place and the file was closed.

The applicant subsequently applied to the Licence Appeal Tribunal.

The respondent argued the application was statute-barred as it was filed beyond the two-year limitation period and the 90-day extension following a failed mediation.

The Tribunal found that while the 90-day extension applied, the applicant filed his application approximately a week after the extension expired.

As the applicant failed to provide authority to extend the limitation period further, the application was dismissed as statute-barred.

The insurer brought a motion to stay the applicant's arbitration hearing pending the completion of additional section 44 insurer's examinations.

The applicant sought a catastrophic impairment determination and submitted rebuttal reports to the insurer's initial assessments.

The insurer argued the rebuttal reports constituted a material change requiring further examinations.

The arbitrator found no material change, noting the differing opinions between occupational therapists did not evidence a declining or changed condition.

The motion for a stay was dismissed.

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

She had a rare, pre-existing brainstem cavernoma that was symptomatic prior to the accident.

The insurer argued the post-accident deterioration was the natural progression of her condition.

The arbitrator found that the applicant did not suffer pre-accident loss of consciousness and accepted the applicant's expert evidence that the torsional force of the collision likely caused increased bleeding in the cavernoma.

The arbitrator concluded that the accident materially contributed to the impairment, tipping the balance from a mild impairment to a life-threatening condition.

Following the dismissal of the appellant's appeal, the respondent sought partial indemnity costs of $5,565.54.

The self-represented appellant argued the amount was excessive and disproportionate to the underlying judgment of $772.06.

The court agreed that 19 hours of preparation was excessive for a straightforward appeal, but noted the appellant bore responsibility for bringing the appeal.

Costs were fixed at $2,500 inclusive of HST and disbursements.

The appellant appealed a Small Claims Court decision awarding the respondent paralegal firm $772.06 on a quantum meruit basis after finding their contingency fee agreement illegal.

The appellant argued the Deputy Judge erred by allowing a late amendment to plead quantum meruit and by applying an incorrect hourly rate.

The Divisional Court dismissed the appeal, finding no palpable and overriding error in the Deputy Judge's conclusions that the amendment caused no prejudice and that the appellant had accepted the bulk of the charges at trial.

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

The insurer denied payment for various medical benefits, assessments, and treatment plans.

At the arbitration hearing, the applicant withdrew her claims for non-earner and attendant care benefits.

The arbitrator found the applicant's evidence regarding her remaining claims to be evasive and lacking in credibility, noting her inability to recall details of the treatments and assessments.

The arbitrator concluded that the applicant failed to prove on a balance of probabilities that the claimed expenses were reasonable and necessary.

The application was dismissed.

The applicant was injured in a motor vehicle accident and claimed statutory accident benefits, including housekeeping, attendant care, medical benefits, and the cost of examinations.

The insurer denied further benefits, arguing the claims were excessive and unsupported.

The arbitrator found the applicant's evidence vague and contradictory, and noted significant discrepancies between the billed services and the applicant's testimony.

The arbitrator concluded the applicant failed to prove the claimed benefits and examinations were reasonable and necessary.

All claims were dismissed.

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

The insurer terminated housekeeping benefits and refused to pay for certain medical benefits and costs of examinations.

The arbitrator found that the applicant's testimony was not credible, noting he did not take time off work and did not mention the accident to his family doctor for two years.

The arbitrator dismissed the claims for medical benefits, housekeeping benefits, and costs of examinations, finding them not reasonable or necessary.