CITATION: Mazaher Shams Nateri v. Economical Insurance Company, 2025 ONSC 1862

DIVISIONAL COURT FILE NO.: 608/24

DATE: 20250324

SUPERIOR COURT OF JUSTICE – ONTARIO

DIVISIONAL COURT

RE: MAZAHER SHAMS NATERI, Appellant

AND:

Economical Insurance Company, Respondent

BEFORE: Backhouse, Lococo, Mew JJ.

COUNSEL:

Peter Cimino for the Appellant, Mazaher Shams Nateri

Angelo G. Sciacca for the Respondent, Economical Insurance Company

HEARD at Toronto: March 24, 2025

Endorsement of the Court Delivered Orally March 24, 2025

[1] This is a statutory appeal of a decision made by Vice Chair Monica Ciriello of the Licence Appeal Tribunal (“LAT”) released on September 9, 2024.

[2] The Appellant, Mazaher Shams Nateri, was involved in an automobile accident on December 13, 2000. He sought accident benefits from the Respondent, Economical Insurance Company, under the Statutory Accident Benefits Schedule, O. Reg. 34/10. Mr. Nateri was denied some benefits on the ground that his injuries fell within the Minor Injury Guideline (“MIG”) limit. The MIG caps medical, rehabilitation and attendant care benefits at $3500. Claimants outside of the MIG may qualify for up to $65,000 in medical, rehabilitation and attendant care benefits.

[3] Mr. Nateri appealed the decision to the LAT on the basis that his psychological impairments and chronic pain warrant his removal from the MIG. He also requested entitlement for various treatment plans and interest on any overdue payment of benefits. The LAT dismissed Mr. Nateri’s claim in its entirety, including his related claims for entitlement to various treatment plans and interest.

[4] The LAT concluded that Mr. Nateri did not meet the onus for establishing removal from the MIG on a balance of probabilities. In considering whether Mr. Nateri proved that he suffered psychological injuries that justified his removal from the MIG, the LAT concluded that Mr. Nateri provided no persuasive evidence to support this. Specifically, the LAT, placed little weight on the psychological assessment completed by Ms. Sarvin Sabet Ghadam, a clinical psychologist who diagnosed Mr. Nateri with various psychological impairments, because it was based solely on Mr. Nateri’s self-reporting.

[5] With respect to chronic pain, the LAT concluded that Mr. Nateri failed to prove that his chronic pain impacted his functionality to remove him from the MIG. The LAT noted that Mr. Nateri did not provide any medical evidence to show that his functionality was impaired. Rather, there was medical evidence to show he sustained soft-tissue injuries and that he engaged in an active physical lifestyle of bodybuilding and an active professional lifestyle as a full-time real estate agent.

[6] Mr. Nateri submits that the LAT erred in law in considering the evidence and violated the rules of procedural fairness or natural justice. He requests an order setting aside the decision and a hearing in respect of all the issues in the decision.

[7] Economical Insurance asks this court to affirm LAT’s decision and dismiss the appeal.

[8] This appeal raises the following issues:

1. Did the LAT err in law in disregarding Mr Nateri’s subjective evidence?

2. Did the LAT err in law in providing inadequate reasons?

3. Did the LAT err in law by violating the rules of procedural fairness?

Court’s Jurisdiction

[9] This court has jurisdiction over this appeal pursuant to s. 11(1) of the Licence Appeal Tribunal Act, 1999, S.O. 1999, c. 12, Sched. G. (“LATA”). Under s. 11(6) of the LATA, appeals from a decision related to a matter under the Insurance Act, R.S.O. 1990, c. I.8, may be made on questions of law only. As the Statutory Accident Benefits Schedule is a schedule to the Insurance Act, s. 11(6) of the LATA applies to this appeal.

Standard of Review

[10] Appellate standards of review apply to statutory appeals. The standard of review on questions of law is correctness: Housen v. Nikolaisen, 2002 SCC 33, [2002] 2 S.C.R. 235, at para. 8. The standard of review on questions of procedural fairness in the context of a statutory appeal is correctness: Law Society of Saskatchewan v. Abrametz, 2002 SCC 29, 470 D.L.R. (4th) 328, at paras. 27 and 30.

Analysis

Issue #1: Did the LAT err in law in disregarding Mr. Nateri’s subjective evidence?

[11] Mr. Nateri submits that the LAT erred in law by failing to consider his subjective evidence, which was the psychological assessment completed by Ms. Ghadam. In holding that the psychological assessment relied solely on Mr. Nateri’s self-reporting regarding his ongoing psychological impairment and disregarding this evidence, he argues that the LAT set a standard that objective evidence is required to establish a psychological impairment.

[12] We find no error of law. LAT explained why it found the psychological assessment report uncompelling, not only because it was based on Mr. Nateri’s self-reporting regarding his ongoing psychological impairment, but, also, because it contained no discussion of the claimant’s clinical notes and records. The LAT also noted the absence of evidence from Mr. Nateri’s treating physicians, of, at a minimum, psychological complaints or concerns, as well as evidence that demonstrated that the complainant had an active physical lifestyle in bodybuilding and an active professional lifestyle as a full-time real estate agent. In short, the LAT found that Mr. Nateri had not met his onus of establishing an impairment of his functionality. He is asking us to re-weigh and reassess the evidence considered by the LAT. That is not the function of a reviewing court.

Issue #2: Did the LAT err in law in providing inadequate reasons?

[13] Mr. Nateri argues that the LAT’s reasons on whether removal from the MIG was warranted based on psychological impairment are inadequate and preclude meaningful review. Mr. Nateri says that the reasons only give a conclusion and do not engage in an analysis of the evidence he provided. We do not agree. The LAT’s reasons demonstrate that it identified and considered the evidence before it and the submissions of the parties. With respect to the psychological report, the LAT identified the shortcomings of the report and in light of these shortcomings chose to give little weight to it. In these circumstances, we conclude that the LAT’s reasons adequately explain its decision and there is no error of law.

Issue #3: Did the Vice Chair violate the rules of procedural fairness?

[14] Mr. Nateri submits that paragraph 21 of the LAT’s decision signifies that it is biased against those having subjective pain complaints, diagnoses, and impairments. He cites a “recent analyses of LAT decisions in 2023”, which indicates that 71% of all decisions are ruled in favour of the insurer, with 10% of decisions being held in favour of the insured (19% being split decisions). Based on these findings, he submits that an informed, cautious observer would have reasonable grounds to believe that the LAT’s decision was not independent, and that it is biased.

[15] We do not accept this ground of appeal. Mr. Nateri did not identify a particular part of the decision which shows bias. This ground of appeal is based on the mistaken assumption that the LAT does not accept subjective evidence when assessing psychological impairments in the context of the MIG. The statistics are of no real value on this appeal.

Conclusion

[16] The appeal is dismissed.

Costs

[17] As agreed upon by the parties, Economical as the successful party, is entitled to costs in the all inclusive amount of $4500.

Backhouse J.

Lococo J.

Mew J.

Released March 24, 2024 2025