OLAT 2025

The applicant sought statutory accident benefits for psychological services following a motor vehicle accident.

The respondent insurer denied portions of four treatment plans, arguing that the first plan was barred by the two-year limitation period and that the hourly rate requested for a social worker in the subsequent plans was unreasonable.

The Tribunal found that the limitation period was not triggered for the first plan because the insurer's initial notice of denial was unclear and non-compliant.

However, the Tribunal dismissed the claims on the merits, finding that the applicant failed to provide objective medical evidence to support the first treatment plan and failed to prove that the higher hourly rate of $149.61 for a social worker was reasonable compared to the $100.00 rate approved by the insurer.

The application was dismissed in its entirety.

The applicant was injured in a motor vehicle accident and sought approval for a treatment plan for massage therapy, physiotherapy, and chiropractic services.

The insurer denied the plan, arguing the applicant's injuries were pre-existing and that he had reached maximum medical recovery.

The Tribunal applied the 'but for' test and found the accident was a necessary cause of the applicant's ongoing impairments.

Preferring the evidence of the applicant's treating chiropractor over the insurer's medical examiner, the Tribunal concluded the treatment plan was reasonable and necessary.

The applicant was awarded the treatment plan amount plus interest.

The applicants sought statutory accident benefits for psychological injuries sustained after their family member witnessed a fatal motor vehicle accident.

In a previous preliminary issue decision, the Tribunal found the applicants were not 'insured persons' under the Schedule because the family member did not sustain a physical injury.

The applicants brought a new application raising a constitutional challenge to the Schedule and tendering new medical reports.

The Tribunal dismissed the application, holding it was barred by res judicata.

The Tribunal found the constitutional issue could have been raised previously, and the new medical reports did not conclusively impeach the original finding that no physical injury was sustained.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found he was subject to the Minor Injury Guideline and not entitled to income replacement benefits due to non-compliance with section 33 of the Statutory Accident Benefits Schedule.

The applicant argued that he was muted during the virtual hearing, that the adjudicator improperly preferred the respondent's evidence, and that new medical reports should be considered.

The Tribunal dismissed the request, finding no breach of procedural fairness, no error of law or fact, and that the allegedly new evidence was either already in the record or could have been obtained previously.

The applicant sought statutory accident benefits following a motor vehicle accident, including treatment plans for social rehab counseling, a catastrophic impairment assessment, and attendant care benefits.

The Tribunal denied the travel expenses for service providers, finding they are not authorized transportation expenses under the Schedule.

The Tribunal also denied the catastrophic impairment assessment costs exceeding the $2,000 statutory cap.

Finally, the claim for attendant care benefits was dismissed because the applicant's own self-reporting and occupational therapy assessments indicated he was independent in his activities of daily living.

The applicant requested reconsideration of a preliminary issue decision that denied her accident benefits under s. 268(1.1) of the Insurance Act.

The applicant was injured when the public transit vehicle she was occupying made a sudden stop, but did not collide with another vehicle or object.

The Tribunal found that the adjudicator did not err in interpreting 'any other object' to mean something external to the vehicle, and that the applicant herself could not be the object.

The request for reconsideration was dismissed.

The applicant sought statutory accident benefits following a 2018 motor vehicle accident, claiming income replacement benefits (IRBs) at $299.65 per week and various medical/rehabilitation benefits.

The Tribunal found the applicant substantially complied with the insurer's section 33 requests for income information.

However, the Tribunal rejected the applicant's IRB calculation, finding the insurer's calculation of $185.00 per week accurately reflected her self-employment and commission income under the Schedule.

The Tribunal denied the proposed treatment plans for physiotherapy and Botox, as the applicant failed to provide the plans or contemporaneous medical evidence to establish they were reasonable and necessary.

The claim for a section 10 award was also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, attendant care benefits, and numerous treatment plans for psychological, cognitive, and occupational therapy assessments and services.

The Tribunal found the claim for the non-earner benefit was statute-barred because the applicant failed to dispute the insurer's clear and unequivocal denial within the two-year limitation period.

The Tribunal dismissed the claims for the treatment plans and attendant care benefits, finding the applicant failed to prove they were reasonable and necessary for accident-related injuries, largely due to significant pre-existing psychological conditions and a lack of supporting medical evidence.

Claims for interest and an award for unreasonable delay were also dismissed.

The applicant sought entitlement to statutory accident benefits for psychological and physiotherapy treatment plans, a general practitioner's assessment, and a special award following a 2019 motor vehicle accident.

The Licence Appeal Tribunal found the applicant was partially entitled to one psychological treatment plan, preferring the treating psychiatrist's clinical notes over the respondent's section 44 assessor.

The remaining psychological and physiotherapy plans were denied as the applicant failed to prove they were reasonable and necessary, with the Tribunal finding the applicant had reached maximum medical improvement physically.

The claim for the general practitioner's assessment was barred by issue estoppel from a previous Tribunal decision.

No special award was granted as the insurer's conduct was not unreasonable.

The respondent insurer requested a reconsideration of a Licence Appeal Tribunal decision that granted the applicant a treatment plan for chiropractic services and an award.

The Tribunal dismissed the reconsideration regarding the treatment plan, finding no error in the adjudicator's assessment.

However, the Tribunal granted the reconsideration regarding the award, finding the adjudicator erred by drawing an unsupported negative inference from the insurer's reliance on a section 44 examination.

The Tribunal cancelled the award and, upon rehearing the issue, found the applicant had not established that the insurer unreasonably withheld or delayed payments.

The applicant's request for costs was also denied.

The appellant, a cannabis retail operator, appealed a Notice of Proposal to revoke its licence.

The Registrar proposed revocation based on the sole owner's conduct during multiple inspections, where he became aggressive, yelled expletives, and forced inspectors out of the store, subsequently sending abusive and threatening messages.

The Tribunal found that the owner obstructed the inspections contrary to section 37(1) of the Cannabis Licence Act, 2018.

Concluding that the appellant would not carry on business with integrity, honesty, or in the public interest, the Tribunal confirmed the proposal and directed the revocation of the licence.

The applicant sought statutory accident benefits after being assaulted by another passenger while riding in an Uber.

The respondent denied benefits, arguing the incident was not an 'accident' under the Statutory Accident Benefits Schedule.

The Tribunal found that while the purpose test was met, the causation test was not.

The assault was an intervening act that broke the chain of causation, and the use or operation of the vehicle was not the direct cause or dominant feature of the applicant's psychological injuries.

The application was dismissed.

The applicant requested reconsideration of a Tribunal decision finding his injuries were predominantly minor and subject to the Minor Injury Guideline (MIG) limit, and denying two treatment plans.

The applicant argued the Tribunal erred in law and breached procedural fairness regarding the insurer's notice obligations under s. 38 of the Statutory Accident Benefits Schedule.

The Tribunal granted the reconsideration in part, finding it erred in law by concluding the insurer's denial of a psychological services treatment plan complied with s. 38(9), as the denial failed to state the insurer's belief that the MIG applied.

Consequently, the applicant was entitled to the psychological services under s. 38(11).

The reconsideration was dismissed regarding the chronic pain assessment, as a subsequent compliant denial cured any initial defect.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that dismissed his application for accident benefits.

The applicant, now self-represented, argued that the Tribunal did not listen to his case properly and did not allow his former representative to speak during a case conference.

The Vice-Chair dismissed the request, finding that the applicant failed to provide new evidence under Rule 18.2(c) and failed to identify any error of law or fact under Rule 18.2(b) that would have impacted the result of the written hearing.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found he remained within the Minor Injury Guideline and was not entitled to an income replacement benefit or disputed treatment plans.

The applicant argued the adjudicator erred in law and fact.

The Tribunal dismissed the request, finding the applicant was attempting to re-litigate issues and failed to establish any clear errors of law or fact that would have likely impacted the result.

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

The respondent denied various treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that a pre-existing condition warranted removal from the MIG under s. 18(2) of the Schedule.

However, the applicant failed to file any evidence or authorities for the written hearing.

The Tribunal found that the applicant did not meet the burden of proof to establish that a pre-existing condition precluded recovery within the MIG.

Consequently, the injuries were deemed predominantly minor, the treatment plans were not considered, and the application was dismissed.

The applicant sought payment for a psychological assessment and a functional abilities evaluation following a motor vehicle accident.

The applicant argued that the insurer's denials were procedurally defective under s. 38(8) of the Schedule, triggering the 'shall pay' provision of s. 38(11).

The Tribunal found that the insurer's denials provided a principled rationale based fairly on the applicant's file, relying on insurer examination reports that concluded the applicant had no accident-related psychological impairment and that his physical injuries had resolved.

The application was dismissed, and claims for an award and interest were denied.

The appellant towing company sought a stay of the Director's orders cancelling its Tow Operator Certificate and Vehicle Storage Certificate pending an appeal.

Applying the RJR-MacDonald test, the Tribunal found there was a serious issue to be tried but the appellant failed to demonstrate irreparable harm.

Furthermore, the balance of convenience favoured denying the stay due to public safety concerns, given the appellant's high commercial vehicle violation rate and recent collision history.

The motion for a stay was denied.

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

The vehicle was impounded after another driver was caught driving it with a suspended licence.

The Licence Appeal Tribunal dismissed the appeal, finding the appellant failed to establish that there was no alternative to the impounded vehicle, as she had access to public transportation and assistance from her mother.

The impoundment was confirmed.

The applicant sought non-earner benefits (NEBs) following a motor vehicle accident, arguing the insurer failed to properly deny the NEB claim after initially paying income replacement benefits (IRBs).

The Tribunal held that the acceptance and payment of IRBs implied a denial of NEBs, as the two benefits are mutually exclusive under the current Schedule.

Furthermore, the applicant failed to meet the substantive test for NEBs, as evidence demonstrated she had returned to work, drove her own vehicle, and performed housekeeping tasks, meaning she did not suffer a complete inability to carry on a normal life.

The application was dismissed.