OLAT 2023

The appellant appealed the 45-day impoundment of his commercial truck under the Highway Traffic Act.

The vehicle was impounded after the appellant's employee was caught driving it while his licence was suspended for a Criminal Code offence.

The appellant argued the vehicle was stolen, as the employee took the keys from an unlocked lockbox without permission while the appellant was on vacation.

The Tribunal found the appellant's evidence credible and concluded the vehicle was taken without consent with the intent to temporarily deprive the owner of it, meeting the legal definition of a stolen vehicle.

The appeal was allowed and the vehicle was ordered released.

The applicant sought an income replacement benefit (IRB) following a motor vehicle accident.

The respondent denied the claim on the basis that the applicant's husband, who was driving the vehicle at the time of the accident, was an excluded driver under the policy.

The Tribunal found that the applicant and her husband intentionally failed to notify the respondent of a material change in risk, barring the applicant from claiming an IRB under section 31(b) of the Schedule.

However, the Tribunal awarded the applicant $2,500 for an accounting report expense incurred to calculate the IRB quantum, finding it was reasonable and necessary at the time it was obtained.

The applicant's claim for an award for unreasonable delay was dismissed.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits, an attendant care assessment, and a chronic pain assessment under the Statutory Accident Benefits Schedule.

The insurer denied the benefits.

The Tribunal found the applicant was entitled to treatment plans for physiotherapy, a chronic pain assessment, and ergonomic equipment (an L-shaped desk and ergonomic chair) as they were reasonable and necessary to address ongoing accident-related pain.

The Tribunal denied the treatment plans for an attendant care assessment and social work services.

The Tribunal also found the insurer failed to properly deny one treatment plan within the required 10 business days under s. 38 of the Schedule.

The applicant's request for an award under s. 10 of O. Reg. 664 was denied, as the insurer's conduct was not unreasonable.

Interest was awarded on the overdue benefits.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing his physical and psychological impairments, along with pre-existing conditions, warranted removal from the Minor Injury Guideline (MIG).

The respondent denied the benefits, maintaining the injuries were minor.

The Tribunal found the applicant failed to provide compelling medical evidence of non-minor physical or psychological impairments, or that pre-existing conditions precluded his recovery within the MIG.

As the MIG limits were exhausted, the claims for additional treatment plans, interest, and an award for unreasonable delay were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs) for both the pre-104 and post-104 week periods, as well as approval for two physiotherapy treatment plans.

The Tribunal found that the applicant did not suffer a substantial inability to perform the essential tasks of her employment, noting inconsistencies between her reported inability to work and her financial records showing continued income.

The Tribunal also found the applicant failed to meet the stricter post-104 week IRB test.

Furthermore, the Tribunal concluded the applicant did not prove the disputed physiotherapy treatment plans were reasonable and necessary.

The application was dismissed in its entirety, with no entitlement to interest or a special award.

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

The matter proceeded to a written hearing.

The applicant failed to file proper initial submissions or evidence, instead submitting an inadmissible settlement proposal.

The applicant's reply submissions consisted entirely of new evidence without written argument, which the Tribunal assigned no weight.

The Tribunal held that the applicant failed to meet his evidentiary burden to establish entitlement to the disputed treatment plans.

The application was dismissed.

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

The insurer denied a treatment plan for a psychological assessment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's psychological symptoms were minor and did not warrant removal from the MIG.

The Tribunal preferred the respondent's psychological assessments over the applicant's, noting the applicant's symptoms were minor and partially attributed to postpartum issues.

The application was dismissed.

The appellant appealed the 45-day impoundment of her motor vehicle under section 50.2 of the Highway Traffic Act on the ground of exceptional hardship.

The vehicle was impounded after the appellant's brother drove it with a suspended licence.

The Licence Appeal Tribunal dismissed the appeal, finding that the appellant failed to demonstrate that there were no alternatives to the impounded vehicle available, as she owned another vehicle and had access to taxi services and rides from family members.

The applicant sought statutory accident benefits for a physiotherapy treatment plan following a motor vehicle accident.

The respondent insurer denied the plan and required the applicant to attend insurer examinations.

The Tribunal found that the respondent's notices denying the plan and requiring the examinations did not comply with the requirements of sections 38(8) and 44(5) of the Schedule, as they failed to provide meaningful medical and other reasons.

Consequently, the applicant was not required to attend the examinations, and the treatment plan became payable under section 38(11)2 upon proof that the expenses were incurred.

The Tribunal also awarded interest and a 10 percent award under section 10 of O. Reg. 664, finding the respondent's prolonged failure to provide meaningful reasons to be stubborn and unyielding.

The applicant sought payment for various treatment plans for psychological therapy, physiotherapy, occupational therapy, and assessments following a motor vehicle accident.

The Licence Appeal Tribunal found that the psychological treatment plans were funded at the appropriate rate for a psychotherapist, rather than a psychologist.

The Tribunal also found that the remaining physical therapy and assessment plans were not reasonable and necessary, as the applicant had reached maximum medical recovery and further assessments would be duplicative.

The claims for a special award and interest were dismissed.

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

The insurer denied income replacement benefits, arguing the applicant's policy was cancelled for non-payment and he failed to submit a disability certificate (OCF-3).

The Licence Appeal Tribunal found the insurer did not prove the applicant knew or ought reasonably to have known his vehicle was uninsured at the time of the accident.

However, the Tribunal held the applicant was not entitled to income replacement benefits for any period prior to submitting a completed OCF-3, as he failed to provide a reasonable explanation for the delay.

The Tribunal also ruled it lacked jurisdiction to grant relief from forfeiture.

The applicant sought medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The Tribunal found the treatment plan for a Cefaly device to treat post-traumatic headaches was reasonable and necessary, noting it provided pain relief without the side effects of medication.

However, the Tribunal denied multiple treatment plans for psychological services, finding the applicant failed to justify the need for 1.25-hour sessions over standard 1-hour sessions, and upheld the insurer's reduced hourly rate for the psychotherapist.

Claims for a special award under s. 10 of O. Reg. 664 were dismissed as the insurer's reliance on its s. 44 assessor was not unreasonable.

The applicant sought income replacement benefits (IRB) and two treatment plans following a motor vehicle accident.

The respondent denied the benefits, relying on multiple independent medical examinations.

The Tribunal found that the applicant met the tests for both pre-104 and post-104 IRB, as he suffered from a substantial inability to perform the essential tasks of his employment and a complete inability to engage in any employment for which he was reasonably suited.

The Tribunal preferred the evidence of the applicant's experts, noting that the respondent's assessors evaluated the applicant in silos and failed to provide an integrated assessment of his physical and psychological impairments.

The treatment plans for chiropractic services and a psychological assessment were deemed reasonable and necessary.

The claim for an award under s. 10 of O. Reg. 664 was dismissed, as the respondent's conduct was not found to be unreasonable.

The applicant sought a determination that she sustained a catastrophic impairment under Criteria 4 and 8 of the Statutory Accident Benefits Schedule following a motor vehicle accident, as well as entitlement to psychological services.

The Tribunal found that the applicant did not meet Criterion 4 because there were no positive findings of a traumatic brain injury on recognized diagnostic imaging.

The Tribunal also found that the applicant did not meet Criterion 8, as the evidence demonstrated she had been working part-time as a personal support worker, which was inconsistent with a Class 5 extreme impairment in work functioning.

The claim for psychological services was dismissed as not reasonable and necessary.

The respondent's request for costs was also dismissed.

The appellant appealed the Registrar of Motor Vehicles' decision to suspend their driver's licence under s. 47(1) of the Highway Traffic Act.

The suspension followed a police report indicating the appellant was found passed out at the wheel and subsequently struck a traffic light pole due to severe hypoglycemia.

The Tribunal found that the appellant suffers from severe hypoglycemia and hypoglycemia unawareness, which significantly interferes with their ability to drive safely.

The Tribunal confirmed the Registrar's decision to suspend the licence, noting that a longer period of stabilization and better diabetic management were required before reinstatement.

The appellants appealed an immediate suspension order issued by the Registrar under the Real Estate and Business Brokers Act, 2002.

The suspension was based on a shortfall of over $341,000 in the brokerage's trust account.

The Tribunal found that the Registrar established a prima facie case of the shortfall and that the appellants failed to provide an explanation or rectify it.

The Tribunal concluded that extending the immediate suspension order pending the full hearing was necessary in the public interest to protect consumer funds.

The applicant sought a determination of catastrophic impairment and entitlement to attendant care benefits following a motor vehicle accident that resulted in a traumatic brain injury.

The central issue was whether the applicant's brain injury restricted his ability to work such that he met the criteria for catastrophic impairment under the GOS-E Guideline.

The Tribunal found that the applicant was capable of working in a reduced capacity, as evidenced by his post-accident construction work and his role teaching martial arts to children, and therefore did not meet the threshold for catastrophic impairment.

The Tribunal also dismissed the claim for attendant care benefits, finding the applicant to be highly functional both physically and cognitively, and denied the claim for interest.

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

After the applicant's counsel was removed from the record, the applicant confirmed their intention to proceed self-represented but failed to attend the scheduled videoconference hearing.

The Tribunal proceeded in the applicant's absence and dismissed the claims, finding the applicant failed to meet their burden of proof.

The respondent's request for costs was also dismissed, as the Tribunal found insufficient evidence that the applicant's failure to attend amounted to unreasonable, frivolous, vexatious, or bad faith conduct.

The applicant sought statutory accident benefits following a 2000 motor vehicle accident.

The parties engaged in mediation and arbitration at FSCO, ultimately reaching a settlement in 2004.

The applicant signed the Settlement Disclosure Notice (SDN) by initialing each page but did not sign the specific acknowledgment line.

Years later, the applicant attempted to reopen the claim, arguing the settlement was invalid due to the missing signature.

The Tribunal found that a binding contract existed, the SDN substantially complied with O. Reg. 664, and the applicant failed to rescind the settlement within the two-business-day cooling-off period.

The application was dismissed.

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

The respondent denied funding for several treatment and assessment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The adjudicator found that the applicant failed to prove he suffered from a pre-existing condition, psychological injury, or chronic pain condition that would remove him from the MIG.

Relying on insurer's examinations and the lack of consistent medical complaints, the adjudicator concluded the injuries were predominantly minor.

The application for disputed benefits and interest was dismissed.