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Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued for removal from the MIG based on psychological impairment, a pre-existing condition, and chronic pain.
The Tribunal found the applicant did not establish an accident-related psychological condition or chronic pain with functional impairment that would warrant removal from the MIG.
As the applicant remained subject to the MIG, the treatment plans were not considered, and the application was dismissed.
Appeal allowed; LAT breached procedural fairness by deciding issue on unargued ground without seeking submissions.
The appellant insurer appealed a Licence Appeal Tribunal (LAT) decision finding that a wheel loader was an 'automobile' for the purposes of statutory accident benefits.
At the LAT hearing, both parties conceded that the wheel loader was not an automobile in ordinary parlance, focusing their arguments on the third part of the Adams test.
However, the LAT decided the case based on the first part of the test without seeking further submissions.
The Divisional Court allowed the appeal, holding that the LAT breached procedural fairness by rejecting the parties' concession without giving them an opportunity to make full submissions on the issue.
The matter was remitted to a different adjudicator.
Tribunal granted expanded standing to participate in appeal of its decision due to respondent's non-participation.
At a case conference, the Licence Appeal Tribunal sought leave to participate substantively in an appeal and judicial review of its decision regarding whether a wheel loader is an 'automobile' under the Statutory Accident Benefits Schedule.
The respondent injured party was not participating in the appeal.
The court applied the Goodis and Ontario Power Generation factors and granted the Tribunal expanded participation on all issues, provided it does not advocate for a particular outcome or adopt an adversarial tone.
Insurer's request for reconsideration dismissed as it improperly attempted to reweigh evidence regarding the definition of an automobile.
The respondent insurer requested a reconsideration of a Tribunal decision which found that the applicant was involved in an 'accident' after being struck by a wheel loader.
The respondent argued that the Tribunal breached procedural fairness and erred in law and fact by misapplying the 'ordinary parlance' test from Adams and improperly weighing evidence regarding a police accident report.
The Tribunal dismissed the request, finding that the respondent had the opportunity to make submissions on the Adams test at the hearing and was improperly attempting to re-litigate the case and reweigh evidence.
The request for reconsideration was dismissed.
A co-defendant lacks standing to oppose the amendment of a third-party claim to which it is not a party.
The defendant Intact Insurance brought a motion for leave to amend its Third-Party Claim against Ashley Zenguele and Justyne Burger-Samuels.
The defendant WTH Car Rental ULC opposed the motion, arguing potential prejudice.
The court applied Rule 26.01 of the Rules of Civil Procedure, finding that WTH Car Rental ULC lacked standing to oppose the amendment as it was not a party to the Third-Party Claim.
The proposed amendments did not introduce a new cause of action and arose from the same factual matrix.
The court found no non-compensable prejudice to WTH Car Rental ULC, noting that any potential exposure to judgment was an outcome of the amended claim, not the amendment itself.
Leave to amend was granted, with a condition that WTH Car Rental ULC be notified of any default judgment proceedings.
Caterpillar wheel loader found to be an automobile in ordinary parlance for statutory accident benefits.
The applicant was struck by a Caterpillar wheel loader equipped with a snow plow while walking on a public roadway.
He applied for statutory accident benefits, which the respondent insurer denied on the basis that the wheel loader was not an 'automobile' and thus the incident was not an 'accident' under s. 3(1) of the Statutory Accident Benefits Schedule.
The Tribunal applied the Adams test and found that the wheel loader was an automobile in ordinary parlance, given its purpose, function, and features such as a steering wheel, braking system, and capability of driving on public roads.
The Tribunal concluded the applicant was involved in an accident, but declined to order a special award against the respondent.
Application for non-earner benefits and treatment plans dismissed due to inconsistent pre-accident evidence and lack of medical support.
The applicant sought non-earner benefits and funding for various treatment plans following a 2016 motor vehicle accident.
The adjudicator found that the applicant did not submit a completed disability certificate until February 2019, precluding non-earner benefits prior to that date.
For the period after February 2019, the adjudicator dismissed the claim because the applicant provided highly inconsistent evidence regarding his pre-accident employment and activities, making it impossible to apply the Heath test to determine if he suffered a complete inability to carry on a normal life.
The adjudicator also dismissed the claims for the treatment plans, finding one statute-barred and all of them lacking contemporaneous medical evidence to prove they were reasonable and necessary.
The application was dismissed in its entirety.
Motion to dismiss for delay denied where plaintiff's counsel suffered severe personal and professional crises.
The defendant brought a motion to dismiss the plaintiff's action for delay under Rule 24.01.
The action arose from a 2013 contractual dispute over HVAC services.
The plaintiff's counsel experienced a series of severe personal and professional crises, including the death of a colleague, illness, and a ransomware attack, which caused significant delay.
The court found the delay was not intentional and that the defendant failed to establish a substantial risk to a fair trial, noting the defendant's own failure to preserve evidence.
The motion to dismiss was denied and the action was permitted to proceed.
Reconsideration request dismissed; no error of law or fact in finding treatment plans not reasonable and necessary.
The applicant requested a reconsideration of a decision denying entitlement to disputed treatment plans on the basis that they were not reasonable and necessary.
The applicant argued that the adjudicator erred in law by applying an incorrect test and that the treatment plans should be deemed incurred under s. 3(8) of the Statutory Accident Benefits Schedule.
The Vice Chair dismissed the request, finding no error of law or fact in the original analysis.
The Vice Chair held that s. 3(8) did not apply because the treatment plans were not payable under the Schedule, and therefore payment was not unreasonably withheld or delayed.
Application for physiotherapy benefits dismissed as the proposed treatment plans were not reasonable and necessary.
The applicant sought statutory accident benefits for two physiotherapy treatment plans following a motor vehicle accident.
The respondent insurer denied the plans on the basis that they were not reasonable and necessary.
The Licence Application Tribunal dismissed the application, finding that the applicant failed to meet the burden of proof.
The Tribunal preferred the evidence of the respondent's physiatrist, who opined that the applicant's condition had plateaued and further facility-based treatment would not aid recovery, over the clinical notes of the applicant's family doctor and physiotherapist which showed only modest improvement.
Applicant entitled to IRB for the first 104 weeks but denied post-104 week and medical benefits.
The applicant was injured in a motor vehicle accident and sought Income Replacement Benefits (IRB) and medical benefits under the Statutory Accident Benefits Schedule.
The respondent denied the benefits.
The Tribunal found the applicant was substantially unable to perform the essential tasks of her pre-accident employment as a cleaner for the first 104 weeks, entitling her to IRB for that period.
However, the applicant failed to prove a complete inability to engage in any employment for which she was reasonably suited beyond the 104-week mark, as she had subsequently worked as a caregiver.
The claims for psychological and physiotherapy treatment plans were dismissed for lack of evidence proving they were reasonable and necessary.
A claim for a special award was also dismissed.
Applicant's injuries fell within the Minor Injury Guideline; claims for additional treatment plans and awards dismissed.
The insurer determined the injuries fell within the Minor Injury Guideline (MIG) and denied treatment plans for physiotherapy and a psychological assessment.
The Tribunal found the applicant failed to provide compelling evidence of psychological injuries, chronic pain, or pre-existing conditions that would warrant removal from the MIG.
The Tribunal concluded the applicant sustained predominantly minor injuries, is subject to the $3,500 funding limit, and is not entitled to the disputed treatment plans, interest, or an award.
Court reduced excessive claimed legal fees and fixed costs at $13,000.
Following dismissal of the plaintiff’s motion to set aside an order dismissing the action, the court addressed the defendants’ claim for costs.
The defendants sought over $27,000 in legal fees and additional disbursements, relying on extensive work performed by multiple lawyers, clerks, and students.
The court accepted that the motion’s outcome was predictable and found the staffing and hours claimed by the defendants excessive given the straightforward nature of the motion.
While acknowledging that law firms may allocate work among multiple professionals, the court held that the losing party should not bear the costs of training junior counsel.
Costs were fixed at $13,000 payable by the plaintiff.
Court approves agreed extension of factum deadlines and directs scheduling of argument.
The parties jointly sought a modification to an existing timetable set out in a prior endorsement regarding the delivery of factums.
The court accepted the parties’ agreement to extend the plaintiff’s deadline for serving a factum and the defendant’s corresponding deadline.
The court ordered the revised timetable and directed that, once factums are delivered, counsel arrange a conference call with the court to schedule a date for oral argument.