Ontario Licence Appeal Tribunal

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

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

The applicant applied to the Licence Appeal Tribunal, arguing for removal from the MIG due to pre-existing conditions, physical injuries including a concussion, and psychological impairments.

The adjudicator found insufficient medical evidence to support the applicant's claims, noting that complaints of concussion and psychological symptoms arose more than a year after the accident and following a separate assault.

The application was dismissed, and the applicant was found to remain subject to the MIG limit.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that his injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on a pre-existing degenerative disc disease and chronic pain.

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

Furthermore, applying the AMA Guides, the Tribunal concluded the applicant did not meet the criteria for chronic pain with functional impairment, noting he continued to work and exercise.

The application was dismissed, and the disputed treatment plan was not considered as the applicant remained subject to the MIG limit.

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

The respondent denied a treatment plan for physiotherapy on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG due to chronic pain with functional impairment, a psychological condition, and a concussion.

The Tribunal found insufficient evidence of functional impairment or a psychological condition, and noted that diagnosing a concussion was outside the scope of practice for the chiropractor who completed the OCF-3.

The application was dismissed, and the applicant was held to the MIG limits.

The appellant appealed the 45-day impoundment of his motor vehicle after it was driven by an individual whose licence was subject to an ignition interlock condition.

The Tribunal found that the appellant failed to exercise due diligence in verifying the driver's licence status, as he merely accepted the driver's representation without checking the expiration date or conditions.

However, the Tribunal found that the impoundment would cause exceptional hardship.

The appellant, who relied on social assistance and supplemented his income through construction work, demonstrated that he had no reasonable alternative to the vehicle for visiting potential customers and transporting tools.

The Tribunal concluded that the loss of the vehicle would cause immediate, significant, and lasting economic loss, and ordered the Registrar to release the impounded vehicle.

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

The respondent denied the benefits, arguing the applicant failed to notify it of his intention to apply within seven days of the accident, as required by section 32(1) of the Schedule.

The applicant argued he had a reasonable explanation for the delay, citing a language barrier and lack of familiarity with the process.

The Tribunal found that the applicant was non-compliant with the time limit and did not provide a reasonable explanation, noting he successfully navigated a property damage claim with another insurer despite the language barrier.

The Tribunal also drew an adverse inference from the applicant's failure to produce the property damage file.

The application was dismissed as statute-barred.

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 for removal from the MIG based on psychological impairment, a pre-existing condition, and chronic pain.

The Tribunal found the applicant did not establish an accident-related psychological condition or chronic pain with functional impairment that would warrant removal from the MIG.

As the applicant remained subject to the MIG, the treatment plans were not considered, and the application was dismissed.

The applicant sought statutory accident benefits for a psychological assessment and two dental claims following a motor vehicle accident.

The applicant passed away prior to the hearing.

The Tribunal found the psychological assessment was not reasonable and necessary as there was insufficient evidence of worsening symptoms since a prior assessment.

The Tribunal also found the dental claims were not payable, as the respondent's denial letter complied with the notice requirements under s. 38(8) of the Schedule and relied on an insurer's examination report concluding the dental issues were not accident-related.

The application was dismissed in its entirety.

The Applicant sought payment for four treatment plans for psychological services and a chronic pain assessment following a motor vehicle accident, as well as an award for unreasonable delay.

The Tribunal found that the Applicant failed to meet their onus to establish that the treatment plans were reasonable and necessary, as they provided no specific submissions or evidence addressing the disputed plans.

The claims for the treatment plans, interest, and a section 10 award were 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 Tribunal found that the applicant failed to provide sufficient objective medical evidence to prove that his psychological injuries or chronic pain warranted removal from the MIG.

The Tribunal also dismissed the claim for a non-earner benefit, as the applicant failed to provide evidence of his pre-accident activities to satisfy the Heath test.

Claims for disputed treatment plans, an award, and interest were also dismissed.

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

The respondent insurer scheduled several insurer's examinations (IEs) to determine ongoing entitlement to income replacement benefits and catastrophic impairment.

The applicant failed to attend or fully participate in three of the IEs, arguing they were excessive and not reasonably necessary.

The Tribunal applied the Travelers criteria and found the requested IEs were reasonably necessary and the applicant failed to provide a reasonable explanation for her non-attendance.

Consequently, the applicant is statute-barred from proceeding with her application under section 55 of the Schedule until she attends the IEs, and the application was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, which the respondent insurer denied.

The Tribunal first addressed preliminary limitation period issues, finding the claim for non-earner benefits (NEB) and one chiropractic plan were not statute-barred due to delayed unequivocal denials, while two other plans were barred.

On the substantive issues, the Tribunal removed the applicant from the Minor Injury Guideline (MIG) based on evidence of chronic pain with functional impairment and somatic symptom disorder.

The applicant was awarded NEB for a closed period due to the insurer's non-compliance with notice provisions, but failed to meet the substantive test for ongoing NEB.

The Tribunal approved several treatment plans for psychological, neurological, and chiropractic services as reasonable and necessary, but denied the applicant's request for a special award.

The appellant motor vehicle dealer appealed a Notice of Proposal to Refuse Registration issued by the Registrar.

The Registrar alleged the appellant breached registration conditions by failing to disclose material facts on Bills of Sale, offering unsupported warranties, and failing to provide a required Letter of Credit.

Furthermore, the Registrar alleged the appellant continued to trade in motor vehicles after its registration expired.

The Licence Appeal Tribunal found the Registrar met its onus, noting compelling evidence that the appellant's sole director continued to sell vehicles while unregistered despite warnings.

The Tribunal confirmed the Registrar's decision to refuse registration, finding that the appellant's conduct afforded reasonable grounds to believe the business would not be carried on in accordance with the law.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and a chiropractic treatment plan.

The Licence Appeal Tribunal dismissed the claim for the non-earner benefit, finding the applicant's inconsistent self-reporting of her pre-accident activities and pre-existing conditions precluded a clear comparison under the Heath test.

However, the Tribunal approved the chiropractic treatment plan, noting the respondent's own occupational therapy assessor found the treatment relieved the applicant's pain.

The Tribunal also ordered the respondent to pay a 50% award under s. 10 of Reg. 664 ($1,300) for unreasonably withholding approval of the treatment plan despite having its own assessor's supportive report.

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

The appellant filed her notice of appeal one day late due to technical issues and brought a motion to extend the time to appeal.

The Licence Appeal Tribunal granted the extension, finding a bona fide intention to appeal and no prejudice to the respondent.

On the merits, the Tribunal found that the impoundment caused exceptional hardship because the appellant had no alternative transportation and required the vehicle to attend medical appointments following recent surgeries.

The Tribunal ordered the Registrar to release the impounded vehicle.

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

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

The Tribunal found the applicant suffered from chronic pain with functional impairment, warranting removal from the MIG.

The Tribunal granted the applicant's requests for chronic pain and psychological assessments, as well as chiropractic and massage treatment, finding them reasonable and necessary.

A psychological treatment plan was partially approved, while a duplicative psychotherapy plan was denied.

The Tribunal declined to order a special award under s. 10 of Regulation 664, finding the respondent reasonably relied on its assessors' opinions, but awarded interest on overdue benefits.

The appellant appealed the 45-day impoundment of her motor vehicle, which occurred after her husband was caught driving it with a suspended licence.

She argued the impoundment would cause exceptional hardship because she needed the vehicle to transport her husband and brother-in-law to medical appointments and for groceries.

The Licence Appeal Tribunal dismissed the appeal, finding the appellant failed to establish that no alternative transportation was available, as she owned a second vehicle used by her son and had not inquired into renting a vehicle.

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

The appellant argued the vehicle was stolen at the time of the impoundment.

The Tribunal found that the appellant's son took the vehicle keys from her purse while she was sleeping, without her consent, and with the intent to temporarily deprive her of the vehicle.

The Tribunal concluded the vehicle was stolen within the meaning of the Act and ordered the Registrar to release the vehicle and reimburse the towing and impound charges.

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

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

The applicant argued for removal from the MIG due to a concussion, psychological impairment, and chronic pain.

The Tribunal found insufficient medical evidence to support these diagnoses, concluding the applicant's injuries were predominantly minor.

The Tribunal also found the respondent's denial notices complied with section 38(8) of the Schedule.

As the applicant was subject to the MIG and the limit was exhausted, the treatment plans were not payable.

Claims for interest and a section 10 award were dismissed.

The applicant sought statutory accident benefits after slipping and falling on an icy sidewalk while completing a food delivery.

He had parked his vehicle, retrieved the food, and was walking to the delivery location when the incident occurred.

The Licence Appeal Tribunal held that the incident was not an 'accident' under section 3(1) of the Statutory Accident Benefits Schedule.

The Tribunal found that the use of the vehicle ended once the applicant retrieved the food and left the parked vehicle, failing the purpose test.

Furthermore, the slip and fall on the icy surface was an intervening event that broke the chain of causation, failing the causation test.

The application was dismissed.

The Registrar issued a Notice of Proposal to revoke the registrations of a motor vehicle salesperson and dealership due to non-compliance with garage register requirements, late remittance of warranty payments, failure to remit HST, and breach of agreed terms and conditions.

The Licence Appeal Tribunal found that while the Registrar established reasonable grounds for belief that the appellants would not carry on business in accordance with the law, revocation was too severe a penalty given the appellants' 30-year unblemished record and subsequent remedial actions.

The Tribunal directed the Registrar not to carry out the revocation and instead imposed strict terms and conditions on the registrations.