OLAT 2025

The applicant, who sustained a catastrophic impairment in a 2009 motor vehicle accident, sought various medical, rehabilitation, and visitor expenses from the respondent insurer.

The Licence Appeal Tribunal denied the claims for prescription expenses, advanced service dog training, an office chair, air brush supplies, a service dog licence, and a replacement iPhone, finding the applicant failed to prove they were reasonable and necessary.

However, the Tribunal granted the claims for sibling visitor expenses, finding them reasonable and necessary to prevent the applicant's isolation due to his impairments.

The applicant, who sustained catastrophic impairments after being struck by a vehicle as a pedestrian, sought statutory accident benefits for alternative housing in Canada and flights from Romania to Toronto.

The applicant had moved to Romania with her parents post-accident but wished to return to Canada for rehabilitation.

The Licence Appeal Tribunal dismissed the claims, finding the applicant failed to substantiate the cost of the requested two-bedroom apartment compared to her pre-accident accommodations, and failed to establish that the flights were essential for her rehabilitation under the Statutory Accident Benefits Schedule.

Claims for an award and interest were also dismissed.

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

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that pre-existing conditions, including diabetes and a prior workplace injury, as well as a psychological impairment, warranted removal from the MIG.

The Tribunal found that the applicant failed to provide compelling medical evidence that his pre-existing conditions prevented maximal recovery within the MIG.

Furthermore, the Tribunal placed greater weight on the respondent's section 44 neuropsychological assessment, finding the applicant did not suffer a psychological impairment warranting removal from the MIG.

The application was dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found he was not catastrophically impaired under Criterion 8 of the Statutory Accident Benefits Schedule.

The applicant argued the adjudicator breached procedural fairness by providing inadequate reasons, displaying bias, and failing to address production order breaches, and that the adjudicator made errors of law and fact in assessing his psychological and social functioning impairments.

The Vice-Chair dismissed the request, finding the adjudicator provided clear and adequate reasons, no reasonable apprehension of bias was established, and the adjudicator's weighing of the expert evidence and application of the legal test for marked impairment were reasonable and free of error.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment under Criterion 7.

The respondent denied the benefits.

The Tribunal found the applicant was not catastrophically impaired, as her Whole Person Impairment rating was 48%, falling short of the 55% threshold.

The Tribunal rejected the WPI ratings for incontinence and headaches provided by the respondent's own expert, finding the incontinence was pre-existing and did not worsen post-accident.

Claims for psychological services, case management, interest, and a section 10 award were also dismissed.

The respondent insurer requested a reconsideration of a decision granting the applicant ongoing income replacement benefits (IRBs).

The adjudicator found that he had made errors of fact regarding the timeline of the applicant's medical restrictions and post-accident employment, and had violated procedural fairness by admitting late evidence in reply submissions without allowing the respondent to address it.

Upon correcting these errors, the adjudicator concluded that the applicant was able to perform the essential tasks of his post-accident employment as a shift supervisor and was not entitled to ongoing IRBs.

The adjudicator also corrected an error of law regarding the repayment of benefits, finding that the insurer was not required to prove material misrepresentation to claim repayment within the one-year statutory period.

The initial decision was varied to deny ongoing IRBs and order the applicant to repay $1,200.00 in overpaid benefits.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits.

The respondent insurer denied several treatment plans, asserting the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued the denial notices were defective under s. 38(8) of the Schedule.

The Tribunal found the respondent's denial notices failed to provide sufficient medical and any other reasons, as they were broad, vague, and did not explain how the MIG conclusion was reached.

Consequently, pursuant to s. 38(11), the disputed treatment plans were deemed payable once incurred.

The Tribunal also awarded interest but declined to order a special award, finding no evidence of intentional withholding of benefits.

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

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant sought removal from the MIG based on chronic pain and psychological impairments.

The Tribunal found the applicant failed to meet the burden of proving chronic pain with functional impairment or a psychological condition warranting removal.

The Tribunal also found the respondent's denial letters were compliant with s. 38(8) of the Schedule, as the applicant failed to comply with s. 33 requests for information.

The application was dismissed.

The appellant appealed a Notice of Proposal to Refuse to Renew its licence under the New Home Construction Licensing Act, 2017.

The Registrar alleged the appellant could not reasonably be expected to be financially responsible due to the loss of project financing and the improper use of unavoidable delay provisions to retain purchaser deposits.

The Tribunal found that the appellant's loss of financing, acts of default, and unreasonable reliance on pandemic-related unavoidable delay to avoid refunding deposits provided reasonable grounds to believe it would not be financially responsible.

The appeal was dismissed and the Registrar was directed to carry out the refusal to renew.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to treatment plans for chiropractic services and a psychological assessment outside the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on a psychological condition and a potential concussion.

The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from a psychological condition or a concussion, relying on the family doctor's clinical notes and an insurer's examination that suggested malingering.

As the applicant remained within the MIG, the disputed treatment plans were not payable, and claims for an award and interest were dismissed.

The applicant was struck by a vehicle as a pedestrian and applied for statutory accident benefits from the respondent, who insured the vehicle.

The respondent denied the claim on the basis that the policy had expired prior to the accident.

The Tribunal found that a sufficient nexus existed between the applicant and the respondent, requiring the respondent to adjust the claim and pay benefits pending any priority dispute.

The Tribunal awarded the applicant an income replacement benefit for the period he was off work due to his injuries, but denied his claims for chiropractic services and an ambulance fee due to insufficient evidence.

The applicant sought entitlement to statutory accident benefits following a motor vehicle accident, disputing the insurer's denial of several treatment plans and expenses.

The Licence Appeal Tribunal found the applicant was entitled to a $2,000 medical services plan for a stress assessment and $15.24 for Swiffer refills, as these were proven reasonable and necessary.

The Tribunal dismissed the claims for the remaining psychological, occupational therapy, and medical services plans, finding the applicant failed to demonstrate how the goals of those plans would be met or why the costs were reasonable.

The applicant was awarded interest on overdue payments, but the claim for a section 10 award was dismissed as the insurer's conduct was not unreasonable.

The applicant sought interest on allegedly overdue Income Replacement Benefits (IRB) and an award for unreasonable delay under s. 10 of O. Reg. 664 following a motor vehicle accident.

The Tribunal found that the applicant failed to provide the necessary financial documentation requested by the insurer to calculate the IRB quantum, triggering s. 33(6) of the Schedule, which suspends the insurer's liability to pay.

Consequently, no benefits were overdue, and no interest was payable.

The Tribunal also dismissed the claim for an award, finding the insurer's requests for documentation were reasonable and supported by legitimate accounting reasons.

The applicant sought a non-earner benefit following a motor vehicle accident.

The matter proceeded to a written hearing, but the applicant failed to file any written submissions or evidence.

The Tribunal proceeded in the applicant's absence pursuant to section 7(2) of the Statutory Powers Procedure Act.

The application was dismissed as the applicant failed to meet their burden of proof.

The respondent requested a reconsideration of a Tribunal decision that removed the applicant from the Minor Injury Guideline (MIG) due to psychological impairment and approved treatment plans.

The respondent argued the Tribunal breached procedural fairness and made errors of law and fact by ignoring evidence and misapplying case law.

The Adjudicator dismissed the request, finding no breach of procedural fairness or errors of law or fact, noting that the respondent was improperly attempting to re-litigate the case and re-weigh the evidence.

The appellant appealed the Registrar of Motor Vehicles' decision to suspend her driver's licence due to a mental health condition.

The Registrar received a Medical Condition Report indicating the appellant suffered from psychosis and cognitive impairment following a recent hospitalization.

The Tribunal found that the appellant's condition, which required a Community Treatment Order and had resulted in two recent hospitalizations, was likely to significantly interfere with her ability to drive safely.

The Tribunal confirmed the suspension, noting the lack of a sufficient period of stability and medical evidence supporting her insight and fitness to drive.

The appellant requested a reconsideration of a Tribunal decision confirming the impoundment of her vehicle under s. 50.2(5) of the Highway Traffic Act.

She argued that the impoundment caused exceptional hardship and submitted new evidence, including a medical note and personal letters.

The Tribunal dismissed the reconsideration request, finding that the new evidence would not have changed the original outcome, as the appellant had access to alternative transportation, making the ground of exceptional hardship unavailable.

The appellant corporation appealed the 45-day impoundment of its motor vehicle, which was driven by an employee with a suspended licence.

The appellant argued the vehicle was stolen and that the impoundment would cause exceptional hardship.

The Licence Appeal Tribunal dismissed the appeal, finding insufficient evidence that the vehicle was taken without consent or with intent to deprive the owner.

The Tribunal also found no exceptional hardship, as the appellant owned other roadworthy vehicles and the owner had alternative means of transportation.

The applicant sought payment for four physiotherapy treatment plans, an award for unreasonable delay, and interest following a motor vehicle accident.

The respondent conceded the applicant was not subject to the Minor Injury Guideline.

However, the applicant failed to provide specific submissions regarding the goals, reasonableness, or necessity of the disputed treatment plans.

Consequently, the Tribunal found the applicant did not meet his burden of proof.

The application for benefits, interest, and an award was dismissed.

The appellant appealed a Notice of Proposal to Refuse Application for a liquor sales licence.

The Tribunal found that the past conduct of the appellant's owners, which included repeated instances of overcapacity, serving alcohol in unlicensed areas, and failing to clear signs of service after hours, established reasonable grounds for belief that the business would not be carried on in accordance with the law and with integrity and honesty.

The Tribunal directed the Registrar to carry out the proposal to refuse the application.