OLAT 2023

The applicant sought various statutory accident benefits following a motor vehicle accident, including attendant care benefits, housekeeping and home maintenance, multiple treatment plans, medical cannabis, and botox injections.

The Licence Appeal Tribunal dismissed the application in its entirety.

The adjudicator found that the applicant's claims for attendant care and housekeeping were inconsistent with her pre- and post-accident level of function, noting she continued to work full-time and her family performed most household chores.

The requested treatment plans and medical expenses were deemed not reasonable and necessary, as they were unsupported by the contemporaneous medical evidence and the applicant failed to provide adequate information to the insurer.

Claims for an award and interest were also dismissed as no benefits were overdue.

The appellant appealed the 45-day impoundment of his motor vehicle under the Highway Traffic Act, claiming exceptional hardship.

During the teleconference hearing, the appellant remarked that he no longer wished to pursue the matter and abruptly disconnected from the call without explanation.

The adjudicator dismissed the appeal pursuant to Rule 3.7.2(b) of the Licence Appeal Tribunal Rules, which allows the Tribunal to make any appropriate order when a party is unable to attend part of a hearing.

The respondent requested a reconsideration of a preliminary issue decision which found she was not involved in an 'accident' when she slipped and fell on ice after exiting a vehicle.

She alleged errors of law and fact, including the Tribunal's failure to consider section 32 of the Schedule, its reliance on binding Divisional Court case law over non-binding Tribunal decisions, and a perceived conflict of interest based on an allegation that the adjudicator and her counsel attended the same law school.

The Tribunal dismissed the request, finding no errors of law or fact, and noting that the bias allegation was factually inaccurate and insufficient to overcome the presumption of impartiality.

The applicant requested a reconsideration of a decision denying her non-earner benefits and physiotherapy treatment plans.

She argued the adjudicator erred in weighing surveillance evidence against her self-reports and failed to properly consider her treating practitioners' reports.

She also sought to introduce a new psychiatric report.

The adjudicator dismissed the request, finding no error of law or fact in the original weighing of evidence, and concluded the new medical report was not contemporaneous and would not have affected the outcome.

The appellant appealed a Notice of Proposal to revoke its registration as a travel retailer under the Travel Industry Act, 2002, based on allegations of failing to submit financial statements.

The parties resolved the issues and consented to the continued registration of the appellant subject to specific conditions, including the timely filing of financial statements and responses to the Registrar.

The Licence Appeal Tribunal disposed of the proceeding without a hearing and issued a consent order incorporating the agreed-upon conditions.

The applicant insurer sought repayment of income replacement benefits (IRBs) paid to the respondent following a motor vehicle accident, alleging willful misrepresentation.

The respondent did not attend the case conference or provide submissions for the written hearing.

The Tribunal found that the respondent willfully misrepresented her post-accident employment status by working for multiple employers while receiving IRBs and failing to disclose this to the insurer.

The Tribunal ordered the respondent to repay $13,947.79, the amount specified in the insurer's notice of repayment, along with applicable interest.

The applicant sought statutory accident benefits following a motor vehicle accident, which were denied by the respondent insurer.

The matter was scheduled for a videoconference hearing.

Neither the applicant nor her counsel attended the hearing, despite receiving notice.

Pursuant to section 7(3) of the Statutory Powers Procedure Act, the adjudicator proceeded in the applicant's absence.

As the applicant failed to present any evidence to satisfy her burden of proving entitlement to the disputed benefits, the application was dismissed.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits beyond the $3,500 limit of the Minor Injury Guideline (MIG).

The respondent insurer denied the claims, arguing the injuries were minor.

The Licence Appeal Tribunal found that the applicant failed to provide objective medical evidence demonstrating that her injuries fell outside the MIG.

Consequently, the applicant was subject to the MIG funding limit, and her claims for additional medical benefits, interest, and an award under s. 10 of O. Reg. 664 were dismissed.

The appellant appealed the 45-day impoundment of her vehicle under the Highway Traffic Act, which occurred after her spouse was caught driving it with a suspended licence.

The appellant argued that the impoundment caused exceptional hardship as she is a single mother on maternity leave who needs the vehicle for work and medical appointments.

The Licence Appeal Tribunal dismissed the appeal, finding that the appellant had access to alternative transportation such as public transit and ride-sharing services, and that inconvenience does not meet the threshold for exceptional hardship.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming his injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain.

The Tribunal found the applicant's medical evidence unconvincing and inconsistent with his treating physicians' records, which showed minimal complaints of pain.

The Tribunal preferred the respondent's physiatry assessment, concluding the applicant suffered minor sprain/strain injuries.

The applicant was not removed from the MIG and his claims for a chronic pain assessment, physiotherapy, and interest were dismissed.

The applicant sought reconsideration of a Licence Appeal Tribunal decision denying entitlement to five treatment and assessment plans, including chiropractic treatment, attendant care, chronic pain, social work, and neurological assessments.

The applicant argued the adjudicator violated procedural fairness and erred in law, particularly regarding the sufficiency of the insurer's denial notices under section 38 of the Statutory Accident Benefits Schedule.

The adjudicator dismissed the request, finding the applicant was attempting to relitigate the weighing of evidence and correctly applied the law that an insured must incur the expenses to trigger the mandatory payment provisions under section 38(11).

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent held the applicant within the Minor Injury Guideline (MIG) and denied three treatment plans.

As a preliminary issue, the Tribunal found the applicant was not barred by the two-year limitation period for one of the plans, as O. Reg 73/20 extended the period by 183 days due to the COVID-19 pandemic.

On the substantive issues, the Tribunal found the applicant failed to demonstrate that his injuries warranted removal from the MIG, preferring the respondent's psychological assessment over the applicant's.

The applicant was entitled to the remaining balance of the $3,500 MIG limit for a disputed physiotherapy plan, but the two psychological treatment plans were denied as they proposed treatment outside the MIG.

The applicant requested a reconsideration of a decision finding he was not catastrophically impaired.

He argued the adjudicator made an error of law and violated procedural fairness by failing to properly apply the AMA Guides regarding concentration, persistence, and pace, as well as activities of daily living and social functioning.

The adjudicator dismissed the request, finding the original decision complied with the methodology in the Guides and that no significant legal or evidentiary mistake was made.

The appellant appealed a Notice of Proposal to Revoke Registration issued by the respondent under the Travel Industry Act, 2002.

The parties resolved the issues in dispute and consented to the continued registration of the appellant subject to terms and conditions.

The Licence Appeal Tribunal issued a Consent Order incorporating the agreed-upon conditions, which included requirements for providing clear invoices regarding cancellation fees and reimbursing consumers when suppliers fail to provide travel services.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found his injuries fell within the Minor Injury Guideline (MIG) and denied his claim for a non-earner benefit (NEB).

The applicant argued the adjudicator made errors of law and acted outside their jurisdiction.

The Tribunal dismissed the request, finding no error of law regarding the evidentiary burden for the NEB claim and refusing to consider a new jurisdictional argument regarding the MIG that was not raised at the original hearing.

The respondent's request for costs was also denied.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found she was not catastrophically impaired and denied four treatment plans.

The Vice-Chair dismissed the reconsideration regarding catastrophic impairment, finding no error of fact or law in the original assessment of causation for the applicant's TMJ.

However, the Vice-Chair found the Tribunal erred in law by relying on the 260-week limitation period to deny the treatment plans without considering their reasonableness and necessity, contrary to the persuasive reasoning in Han v. Wawanesa.

Upon reviewing the merits, the Vice-Chair found all four treatment plans for occupational therapy, home modifications, and physiotherapy to be reasonable and necessary to address the applicant's accident-related impairments.

The reconsideration was granted in part, and the treatment plans were approved.

The appellant appealed the 45-day impoundment of her vehicle under section 50.2 of the Highway Traffic Act.

The vehicle was impounded because her spouse was driving it while his licence was suspended for a Criminal Code conviction.

The appellant argued the impoundment would cause exceptional hardship.

The Licence Appeal Tribunal dismissed the appeal, finding that the appellant had alternative means of transportation, such as her father's car, public transit, and another vehicle owned by her husband, and therefore failed to meet the test for exceptional hardship.

The appellant appealed the 90-day impoundment of her vehicle, which was being driven by her mother whose driver's licence was suspended.

The appellant argued that the impoundment would cause exceptional hardship due to her medical condition and reliance on the vehicle.

The Tribunal found that the exceptional hardship ground of appeal was not available to the appellant under s. 50.2(4) of the Highway Traffic Act because she was the owner of the vehicle during a previous impoundment.

The impoundment was confirmed.

The appellant appealed the 45-day impoundment of his vehicle, which was seized when his son was caught driving it with a suspended licence.

The Licence Appeal Tribunal dismissed the appeal, finding that the appellant failed to exercise due diligence to ensure his son's licence was valid before lending the vehicle.

The Tribunal also found no exceptional hardship, as the appellant had access to other vehicles and alternative transportation options for work and medical appointments.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied his claims for an income replacement benefit, attendant care, and medical benefits following a motor vehicle accident.

The applicant alleged the Tribunal violated procedural fairness, made errors of law and fact, heard false evidence, and sought to introduce new evidence.

The adjudicator dismissed the reconsideration request, finding no breach of procedural fairness in the Tribunal's procedural rulings or hearing management.

While acknowledging minor factual errors in the original decision, the adjudicator concluded they were inconsequential and would not have changed the outcome regarding causation of the applicant's physical and psychological impairments.