The plaintiff, Arsim Grajqevci, suffered personal injuries from a motor vehicle accident.
Following a jury award, the statutory third party, Allstate Insurance Company, brought a motion for directions on two issues: (1) whether a threshold determination under s. 267.5(15) of the Insurance Act was required for non-pecuniary general damages and health care costs, even though the award for pain and suffering was reduced to nil by deductibles; and (2) whether payments received by the plaintiff from the Government of Ontario under the Ontario Disability Support Program (ODSP) and Ontario Works (OW) should be deducted from the award for past loss of income.
The court ruled that a threshold determination was not required when the plaintiff was not entitled to an award for health care expenses or non-pecuniary loss after deductibles.
The court also found that OW and ODSP payments were not deductible because Allstate failed to establish they were "in respect of the incident" (the motor vehicle accident), as the benefits were primarily related to the plaintiff's other health conditions (HIV, tuberculosis).
