O.S. v. Certas Home and Auto Insurance Company, 2020 CanLII 42665

Citation: O.S vs. Certas Home and Auto Insurance Company, 2020 ONLAT 18-006633/AABS

Released: June 5, 2020

In the matter of an Application pursuant to subsection 280(2) of the Insurance Act, RSO 1990, c I.8., in relation to statutory accident benefits.

Between:

O.S

Applicant

and

Certas Home and Auto Insurance Company

Respondent

DECISION

ADJUDICATOR:

Sancia Pinto

APPEARANCES:

For the Applicant:

Clifford Singh, Counsel

For the Respondent:

Rosalind W. Eastmond, Counsel

Heard by way of written submissions

OVERVIEW

1The applicant O.S. (“O.S.”), was injured in an automobile accident (“the accident”) on May 6, 2015 and sought insurance benefits pursuant to the Statutory Accident Benefits Schedule – Effective September 1, 2010¹ (the “Schedule”). The applicant applied to the Licence Appeal Tribunal – Automobile Accident Benefits Service (the “Tribunal”) when his claims for benefits were denied by the respondent.

2The parties were unable to resolve the issues in dispute at the case conference held on November 22, 2018, and the matter proceeded to a written hearing. A review and consideration of all submissions and evidence filed with the Tribunal forms the basis for this decision.

PRELIMINARY ISSUE

I. New Issues

i. Is the applicant entitled to receive a medical benefit in the amount of $1,447.88 for occupational therapy services, recommended by Apex Health Network in a treatment plan dated July 11, 2016, and denied by the respondent on September 21, 2016?

ii. Is the applicant entitled to receive a rehabilitation benefit in the amount of $1,320.59 for assistive devices, recommended by Apex Health Network in a treatment plan dated July 19, 2016, and denied by the respondent on September 21, 2016?

3In O.S.’s written submissions, he has listed as issues in dispute to this written hearing the above noted treatment plans for occupational therapy services and assistive devices that were not part of the Order of Adjudicator Msosa dated November 29, 2018 (the “Order”).

4Following a review of the respondent’s submissions, it appears that both the above treatment plans have been approved and paid in full as noted in the benefits statement and correspondence provided by the respondent to the applicant on January 26, 2017 and March 31, 2017. The applicant did not provide any reply submissions or evidence disputing the respondent’s submissions on the above noted treatment plans. Given the foregoing, it is unnecessary to consider the reasonableness and necessity of the treatment plans. Accordingly, I will determine only those issues that remain in dispute as listed in the Order.

ISSUES TO BE DECIDED

5The following issues are in dispute:

1. Is O.S. entitled to receive a medical benefit in the amount of $2,936.00 for chiropractic treatment, recommended by Joint and Muscle in a treatment plan dated January 9, 2018, and denied by the respondent on January 18, 2018?

2. Is O.S. entitled to payments for the cost of examinations in the amount of $2,881.50 for an orthopaedic assessment, recommended by Meditecs Independent Medical Examinations in a treatment plan dated January 20, 2017, and denied by the respondent on February 2, 2017?

3. Is O.S. entitled to payments for the cost of examinations in the amount of $7,401.50 for a neuropsychological assessment, recommended by Meditecs Independent Medical Examinations in a treatment plan dated January 20, 2017, and denied by the respondent on January 27, 2017?

4. Is O.S. entitled to payments for the cost of examinations in the amount of $26,400.00 for a multi-disciplinary catastrophic impairment assessment (the “CAT assessment”), recommended by Novo Medical Assessments in a treatment plan dated January 19, 2018, and denied by the respondent on February 2, 2018?

5. Is the respondent liable to pay an award under Regulation 664 because it unreasonably withheld or delayed payments to O.S.?

6. Is O.S. entitled to interest on any overdue payment of benefits?

RESULT

6For the reason set out below, I find that the medical benefits and cost of examinations are not payable. O.S. is not entitled to an award or interest.

ANALYSIS

Issue 1: Chiropractic treatment plan dated January 9, 2018

7I find that the treatment plan for chiropractic treatment dated January 9, 2018 submitted by Joint and Muscle (“the Chiropractic Treatment Plan”) is not reasonable and necessary as there is insufficient objective medical evidence provided by O.S. to support the entitlement.

8Section 14 of the Schedule provides that an insurer is liable to pay medical benefits to an insured person who sustains an impairment as the result of an accident.

9Section 15 of the Schedule provides that medical benefits must pay for all reasonable and necessary medical expenses incurred by the insured person as a result of the accident. Thus, the applicant bears the onus of proving on a balance of probabilities that each treatment and assessment plan is reasonable and necessary.²

10O.S. submits that the treatment is reasonable and necessary and relies on the recommendation made by her physician Dr. Rachel Hamilton (“Dr. Hamilton”) in a letter dated August 15, 2016.³

11The respondent submits that the Chiropractic Treatment Plan is a duplication of the treatment plan of March 28, 2017 that has not been invoiced and, presumably, not incurred at the time of submission of the disputed Chiropractic Treatment Plan. O.S. has not provided any reply submissions for my consideration on the duplication, if any, of the Chiropractic Treatment Plan.

12My review of the medical records around the time of the Chiropractic Treatment Plan of January 9, 2018 does not support the need for any chiropractic treatment to assist with any ongoing injuries or functional impairments as a result of the accident.

13I find Dr. Hamilton’s recommendation for chiropractic treatment from 2016 does not support the reasonableness or necessity of the Chiropractic Treatment Plan for further treatment in 2018. There is no evidence that Dr. Hamilton assessed O.S. around the time of the submission of the January 2018 Chiropractic Treatment Plan. Her brief letter from 2016 simply recommends that the applicant continue with chiropractic therapy to treat all pain. Dr. Hamilton does not make any recommendations on duration, frequency or the appropriate number chiropractic sessions for O.S. In the medical records submitted by O.S. there does not appear to be any follow up with Dr. Hamilton since the first treatment plan for chiropractic treatment was approved in March of 2017 and presumably accessed by O.S.

14It is further unclear how much of the previously approved chiropractic treatment from March of 2017 has been used by O.S. From my review of the treatment goals as listed on the Chiropractic Treatment Plan, there are no details provided by the chiropractor on the improvement from the previous treatment plan. I do not have the benefit of the records from Joint and Muscle and it is challenging to determine the improvement, if any, made over the course of care and what residual problems exist that would warrant further chiropractic treatment. In addition, my review of the medical records submitted by O.S. from his treating family doctor at the time, Dr. Furheen Iftikhar (“Dr. Iftikhar”) and the records from the orthopaedic surgeon, Dr. Gary Stamp (“Dr. Stamp”) indicates there is no recommendation that O.S. seek chiropractic treatment.

15Having considered the submissions and medical evidence before me, I find that O.S. has failed to establish that the Chiropractic Treatment Plan is reasonable and necessary.

Issue 2 - Orthopaedic Assessment treatment plan dated January 20, 2017

16I find insufficient compelling medical evidence to support the treatment plan dated January 20, 2017 for an Orthopaedic assessment (“the Orthopaedic Treatment Plan”).

17O.S. has been under the care of his orthopaedic surgeon Dr. Stamp since May of 2016. In June of 2016, O.S. underwent arthroscopic surgery for the left rotator cuff. On January 20, 2017, O.S. submitted a treatment plan for an orthopaedic assessment. The goal as listed on the Orthopaedic Treatment Plan was to determine O.S.’s functional limitations, surgical outcome, other treatment options and recommendations as it pertains to his shoulders.

18O.S. submits that the orthopaedic assessment is reasonable and necessary to explore his serious and chronic bilateral shoulder injury and to assist his healthcare practitioners in recommending appropriate ongoing treatment for his recovery.

19The respondent’s position is that, following the diagnosis and rotator cuff surgery, O.S. was under the care of his family doctor Dr. Iftikhar and his orthopaedic surgeon Dr. Stamp. In addition, Dr. Stamp referred O.S. for physiotherapy at St. Joseph’s Health Centre and his treating physiatrist Dr. Jean Pierre Sarco (“Dr. Sarco”) provided a management plan including therapeutic exercise, pain control and follow up appointments.

20I agree with the respondent’s position. From the medical evidence submitted, it appears that Dr. Stamp has assessed and treated O.S. for his accident related impairments since May of 2016. He has provided a diagnosis, prognosis and treatment recommendations following his surgery as noted in his letter to the family doctor on October 18, 2016. Dr. Stamp’s last assessment of O.S. post surgery contained recommendations for physiotherapy and home exercises. I find that Dr. Stamp was in a good position to determine any further surgical outcomes and provide recommendations for ongoing treatment. In addition, Dr. Sarco’s April 2017 physiatry consult report provides a comprehensive management plan with treatment recommendations to treat O.S.’s bilateral shoulder pain.

21For these reasons, my finding is that O.S. has failed to satisfy his burden of showing that, on a balance of probabilities, the orthopaedic assessment is reasonable and necessary.

Issue 3 - Neuropsychological Assessment treatment plan dated January 20, 2017

22I find that there is a lack of evidence submitted by O.S. to support the reasonableness and necessity of the treatment plan dated January 20, 2017 for a neuropsychological assessment to explore any ongoing impairments as a result of the accident (“the Neuropsychological Treatment Plan”).

23The goal of the Neuropsychological Treatment Plan was to examine O.S.’s neurocognitive and emotional functioning and to provide recommendations for treatment including treatment recommendations for his forgetfulness.

24In his submissions, O.S. relies on the report of the chiropractor Dr. Amir Owliaei (“Dr. Owliaei”) and the symptoms reported to Dr. Owliaei during the assessment on January 14, 2018, including but not limited to headaches and dizziness. O.S. further submits that the assessment is reasonable and necessary to explore the ongoing neurological symptoms and assist his health care practitioners in recommending the appropriate treatment for his recovery. I note that O.S.’s submissions and evidence do not highlight any specific records from the family doctor or other treating practitioners in the few months before or after the submission of the Neuropsychological Treatment Plan to support compelling ongoing neurological symptoms or ongoing issues with forgetfulness from the accident that warrant the need for a neuropsychological assessment.

25The respondent submits that the medical evidence does not suggest that O.S. has suffered a traumatic brain injury or the onset of cognitive concerns. The respondent further submits that the family doctor records do not support the presence of ongoing neurological concerns.

26From my review of the medical evidence for the period of the denied Treatment Plan including the April 9, 2017 report of the physiatrist Dr. Sarco to Dr. Hamilton, I note that O.S. had an unremarkable neurological examination and that Dr. Sarco found the sensory examination and reflexes were unremarkable, with normal findings. These findings were noted by Dr. Sarco in his report shortly after the Neuropsychological Treatment Plan was submitted. There is a lack of persuasive medical records from the family doctor or Dr. Sarco on recommendations with respect to neurological concerns or any reasonable evidence to support ongoing issues with O.S.’s neurocognitive and emotional functioning.

27I put limited weight on the subjective self-reported symptoms by O.S. to Dr. Owliaei as he did not have the benefits of O.S.’s medical records for review at the time of the assessment. There is no cogent evidence from any of O.S.’s treating medical practitioners to support cognitive issues, including any issues with memory and concentration, requiring specialized testing or assessment.

28Furthermore, I find that O.S.’s self-reports regarding his impairments to Dr. Owliaei more than a year after the submission of the Neuropsychological Treatment Plan are not as persuasive as the lack of evidence in the family doctor records and the report from Dr. Sarco. The medical records submitted by O.S. during the time period of the submitted Neuropsychological Treatment Plan fail to demonstrate ongoing neurological limitations or the need for further medical treatment that the treatment plan is meant to assess. For these reasons, I find the neuropsychological assessment not reasonable or necessary.

Issue 4 - Multidisciplinary CAT assessments treatment plan dated January 19, 2018

29Section 25(1)5 of the Schedule provides that an insurer shall pay for reasonable fees for the determination of whether the insured person has sustained a catastrophic impairment, including any assessment or examination necessary for that purpose. This is to be read in combination with s. 25(5)(a), which limits the cost of any one assessment or examination to $2000.00.

30O.S. bears the onus of proving on a balance of probabilities that each assessment in the treatment is reasonable and necessary and, if so, that the fees charged for each individual assessment are reasonable.⁴ In addition, O.S. bears the onus of proving that it is reasonable and necessary for him to investigate the possibility that he is catastrophically impaired by bringing forward compelling medical evidence to support that he has a specified condition that warrants assessment.⁵ An assessment on the probability that O.S. would meet the definition of CAT is not a relevant consideration at this juncture when determining the reasonableness and necessity of the treatment plan for multidisciplinary CAT assessments.

31Based on the available evidence before the Tribunal and my reasons below, I find that it is not reasonable or necessary that O.S. explore whether he is catastrophically impaired. I find O.S. is not entitled to payment for the multidisciplinary CAT assessments (the “CAT assessments”) as listed on the treatment plan, as they are not reasonable and necessary.

32The treatment plan in dispute for the CAT assessments were completed by Dr. Naguib Milad (“Dr. Milad”), a physician with the [Medical Centre], and dated January 19, 2018 (“the CAT Treatment Plan”).⁶ Prior to the completion of the CAT Treatment Plan, chiropractor Dr. Owliaei completed a Pre-CAT assessment report on January 14, 2018 to support the Treatment Plan.⁷

33O.S. submitted one treatment plan at issue in this hearing, outlining several assessments contained within the treatment plan. The test to determine whether the examinations are required is under section 15 and the test is whether each examination is reasonable and necessary. The CAT Treatment Plan is composed of the following:

1. Medical Physical Assessment;

2. Executive Summary and Rating of Whole Person Impairment;

3. Biopsychosocial Assessment;

4. Medical Review for CAT Assessment;

5. Functional Abilities Evaluation;

6. Psychiatric Evaluation;

7. Neuropsychological Assessment and Testing (Part 1 and Part 2);

8. Occupational Therapy In-Home Assessment;

9. Occupational Therapy Situational Assessment;

10. Neurological Assessment;

11. Chiropractic Assessment;

12. OCF-18 completion;

13. OCF-19 completion; and,

14. Electromyography Analysis.

34The CAT Treatment Plan lists the following injuries and sequelae information: tension-type headache, low back pain, pain in thoracic spine and radiculopathy. The goal of the CAT Treatment Plan is to examine if O.S. meets the criteria of catastrophic impairment.

35In his submissions, O.S. relies on the pre-CAT assessment report of Dr. Owliaei to support the CAT Treatment Plan. O.S. submits that it has been over two years since the accident and that Dr. Owliaei’s report concluded that, given the plateau of improvement from O.S.’s injuries, that catastrophic impairment may apply given that his condition is unlikely to improve and cease to be a catastrophic impairment. In addition, O.S. submits that his injuries are catastrophic given his serious orthopaedic injuries requiring surgery and his ongoing neurological and psychological symptoms.

36O.S further submits that the purpose of a CAT assessment is to determine on a balance of probabilities whether it is reasonable and necessary for him to determine whether he is catastrophically impaired.⁸

37The respondent’s position is that O.S. does not immediately require funding from a higher tier level of benefits as O. S. still has $27,738.48 available under the current policy limits. The respondent submits that O.S. has not submitted an OCF-19 for a determination of whether his impairment is a catastrophic impairment.

38The respondent further submits that the medical evidence submitted to date, including O.S.’s functional capacity and limitations, does not support that it is reasonable or necessary for O.S. to explore the possibility that he is CAT impaired. In reaching a determination as to whether the CAT assessments are reasonable and necessary, the respondent argues that a claimant’s functional capacity and limitations are factors to be considered.⁹ The respondent submits that, based on the available medical evidence, O.S. is independent in his activities of daily living, he continues to drive, travelled to Saudi Arabia shortly before the submission of the CAT Treatment Plan for CAT assessments and, most importantly, continued to work full time.

39In addition, the respondent submits that O.S. started seeing a new family doctor, Dr. Huma Ul Haq (“Dr. Ul Haq”) on December 20, 2017 and continued to see him in 2018 with only one visit as accident related, according to the decoded OHIP summary. The respondent submits that none of Dr. Ul Haq’s records have been provided and that Dr. Ul Haq’s records are important especially around the time that O.S. applied for payment of CAT assessments to support any impairments and functional limitations.

40The respondent has relied on the decision of C.A. v. Intact, where the adjudicator addressed the issue of whether any of C.A.'s medical practitioners believed it was reasonably possible that C.A. was catastrophically impaired. The respondent highlights that the adjudicator found that, based on the medical evidence from C.A.’s physicians, there was no evidence that C.A. was possibly catastrophically impaired, as a determinative factor in the issue of reasonable expenses for assessment.¹⁰

41O.S. has an obligation to support his position for CAT assessments by providing persuasive medical evidence that shows that he continues to suffer from accident related impairments that warrant further investigation that he may possibly be catastrophically impaired. I find the available medical evidence insufficient to substantiate that O.S. had ongoing specified conditions to support the components of the CAT assessment and his position that the CAT assessments are reasonable and necessary.

42O.S. had been under the care of his old family doctor Dr. Iftikhar until early December of 2017 and his new family doctor, Dr. Haq starting December 20, 2017. In addition, he received care from his treating physiatrist Dr. Sarco and his treating orthopaedic surgeon Dr. Stamp. He was also previously seeing a psychotherapist until July of 2017. It appears that none of these medical practitioners and treatment providers were consulted by either Dr. Milad in the preparation of his CAT Treatment Plan or by Dr. Owliaei in the completion of his pre-CAT assessment. In reviewing the totality of medical records submitted before me, there is insufficient compelling evidence that any of these treating professionals believed that it was reasonably possible that O.S. could be catastrophically impaired or that he should explore the possibility of CAT assessments.

43In reviewing the CAT Treatment Plan, I note that under part 7 prior and concurrent conditions, Dr. Milad has marked this component as “unknow”. The activity limitations section of the CAT Treatment Plan outlines that O.S. experiences functional limitations and difficulties in performing activities of daily living but does not list specific activities. With regard to O.S.’s ability to carry on his pre-accident employment or any impairments that may affect his ability to engage in his tasks of employment, Dr. Milad has further marked this section as “unknow”. I find that the CAT Treatment Plan is vague, minimal and fails to support why each individual assessment is reasonable and necessary based on O.S.’s accident related injuries, functional limitations and any difficulties in performing his activities of daily living.

44From reviewing Dr. Owliaei’s pre-CAT assessment report, I note that he has not reviewed any of O.S.’s medical records or consulted with his treating practitioners in coming to the determination that multidisciplinary CAT assessments are warranted. Dr. Owliaei did not have access to the family doctor records, the records from the orthopaedic surgeon, the records from the physiatrist, the records from the rehabilitation centers or any other medical records for consideration.

45The medical history and the listed a range of conditions under the diagnosis section of his report is solely based on what O.S. reported to him during the assessment. Furthermore, it is unclear what tests, if any, were carried out during the assessment or if Dr. Owliaei’s opinions and conclusions were just based on a series of questions that he asked O.S. to determine that CAT assessments were required. Dr. Owliaei did not have the benefits of reviewing O.S.’s medical records to support his findings and has primarily relied on the subjective reports that O.S. provided during the assessment, which contradicts what is noted in the medical records of O.S.’s treating doctors as outlined above. I find that Dr. Owliaei’s report is not persuasive and has serious limitations. His conclusions and recommendations for CAT assessments are not supported by the medical evidence.

46I put limited weight on his report as I find that his recommendations for the CAT assessments are not well reasoned and would have been better supported if he had the opportunity to consider the medical records from O.S.’s treating practitioners and specialists. Additionally, I note that O.S. has nowhere near exceeded the non-catastrophic funding limit requiring him to explore the possibility of accessing additional resources.

47The available medical records around the time of the submitted CAT Treatment Plan fail to show functional limitations that would warrant CAT assessments. While O.S. did have some limitations around June of 2016 when he had rotator cuff surgery, by April of 2017, Dr. Sarco reported that O.S. was independent in his activities of daily living. Dr. Sarco’s records around April of 2017, as outlined above, note that O.S. had an unremarkable neurological examination and that the sensory examination and reflexes were unremarkable, with normal findings. O.S. has not pointed to any specific medical entries in his submissions to support ongoing neurological concerns or conditions that the CAT assessments are meant to explore.

48In addition, as noted above, O.S. was under the care of Dr. Stamp, orthopaedic surgeon and had not returned to him for any additional follow ups since October of 2016. Dr. Stamp recommended that O.S. attend physiotherapy after his shoulder surgery and the records provided by O.S. suggest that he stopped attending physiotherapy treatment around August of 2016. I do not have the benefit of any updated physiotherapy records or the records from any chiropractic treatment received by O.S. to support any ongoing accident related injuries that require CAT assessments.

49Furthermore, the psychological components of the CAT assessments are not supported based on the medical evidence before me. I have also reviewed all the medical records as it pertains to O.S.’s psychological condition and note that there has been no further psychological treatment received since the completion of the 12 sessions for psychotherapy treatment that ended on July 28, 2017.¹¹ While there have been recommendations by the psychotherapist for further psychotherapy in 2017, O.S. has not submitted any further treatment plans or records to support follow up treatment received for any ongoing psychological impairments as a result of the accident that warrant further assessment or treatment. In addition, the family doctor records that have been submitted by the applicant do not document any evidence of deterioration in functioning or ongoing psychological impairments in the months before the submission of the CAT Treatment Plan.

50The limited available medical evidence fails to support ongoing accident related physical functional limitations/impairments or restrictions or a psychological diagnosis that would necessitate CAT assessment. The records of the family doctor, Dr. Iftikhar that have been provided until early December of 2017 shows some entries in 2017 where O.S. complains of pain in his shoulders but these complaints are sporadic at best and I find no deterioration in his condition. In addition, the family doctor discussed treatment options with O.S. including pursuing cortisone injections with Dr. Sarco if he continued to experience ongoing issues with his shoulder. The family doctors’ medical records indicate that O.S. would advise if he needed a referral back to Dr. Sarco for further treatment of his shoulders.

51O.S. has not submitted any additional medical records to suggest that he sought any further treatment for his shoulder pain from Dr. Sarco or any other specialist after he saw his family doctor in September of 2017. I have been provided with O.S.’s medical records only until early December of 2017 prior to the submission of this Treatment Plan and there is no compelling medical evidence to suggest any ongoing accident related physical or psychological impairments that would support the possibility that O.S. may be catastrophic. The medical records show that O.S. continues to drive, is independent in his activities of daily living and continues to work full time, albeit with some difficulty.

52Based on the totality of medical evidence before me, I find there is a lack of medical evidence to support that it is reasonable or necessary for O.S. to explore the possibility of CAT due to his accident related injuries. I agree with the respondent that the records of the new family doctor, Dr. Ul Haq, around the time of the submission of the CAT Treatment Plan would have been helpful in determining if O.S.’s injuries warrant pursuing the CAT assessments proposed in the CAT Treatment Plan. There is no explanation in O.S.’s initial submission and O.S. did not provide any reply submissions to the respondent’s submissions on the lack of medical evidence and the fact that Dr. Ul Haq’s records were not provided to support O.S.’s claim for the CAT assessments.

53With the onus on O.S. to prove his entitlement to the benefit, I find the onus has not been satisfied, and accordingly, I find that O.S. is not entitled to the multidisciplinary CAT assessments.

Issue 5 - Award under Regulation 664

54Section 10 of Ontario Regulation 664 states that an amount of up to 50 per cent with interest on all amounts owing may be awarded if an insurer has unreasonably withheld or delayed payments.

55The claim for an award was listed as an issue in dispute in the Order of Adjudicator Msosa but the applicant has not addressed or provided any details regarding the claim for an award in its written submissions. As I have found that there are no payments payable, the respondent cannot have unreasonably withheld or delayed payments. The claim for an award is dismissed.

Issue 6 - Interest

56Section 51 of the Schedule sets out the criteria for assessing and awarding interest on overdue payments.

57In this case, the applicant is not entitled to interest because no payment is due from the respondent.

CONCLUSION

58For the reasons set out above, I find that O.S.:

i. Is not entitled to the treatment plan for chiropractic treatment;

ii. Is not entitled to the treatment plan for an orthopaedic assessment;

iii. Is not entitled to the treatment plan for a neuropsychological assessment;

iv. Is not entitled to the treatment plan for multidisciplinary CAT Assessments;

v. Is not entitled to an award or interest; and,

vi. The application is dismissed.

Footnotes

1. 1O. Reg. 34/10.
2. 2Scarlett v. Belair Insurance, 2015 ONSC 3635.
3. 3Dr. Rachel Hamilton Letter dated August 15, 2016.
4. 416-002858 v. State Farm Insurance Company, 2017 CarswellOnt 20325 (ON LAT); C.A. v Intact, 2018 CanLII 130861 (ONLAT).
5. 5Applicant and TD Insurance, 2018 CanLII 13167 (ON LAT).
6. 6OCF-18 completed by Dr. Amir Owliaei, dated January 19, 2018.
7. 7Dr. Owliaei Pre-CAT Assessment Report dated January 14, 2018.
8. 8Applicant and TD Insurance, 2018 CanLII 13167 (ON LAT).
9. 9J.M. v Certas Home and Auto Insurance Company, 2018 CanLII 132564 (ON LAT).
10. 10C.A. v Intact, 2018 CanLII 130861 (ONLAT). Respondent's Book of Authorities at Tab 4.
11. 11Sara Jane Friesen Report dated August 24, 2017.