Paul A. Oddi

The respondent insurer requested a reconsideration of a Tribunal decision which found that the applicant was involved in an 'accident' after being struck by a wheel loader.

The respondent argued that the Tribunal breached procedural fairness and erred in law and fact by misapplying the 'ordinary parlance' test from Adams and improperly weighing evidence regarding a police accident report.

The Tribunal dismissed the request, finding that the respondent had the opportunity to make submissions on the Adams test at the hearing and was improperly attempting to re-litigate the case and reweigh evidence.

The request for reconsideration was dismissed.

The applicant was struck by a Caterpillar wheel loader equipped with a snow plow while walking on a public roadway.

He applied for statutory accident benefits, which the respondent insurer denied on the basis that the wheel loader was not an 'automobile' and thus the incident was not an 'accident' under s. 3(1) of the Statutory Accident Benefits Schedule.

The Tribunal applied the Adams test and found that the wheel loader was an automobile in ordinary parlance, given its purpose, function, and features such as a steering wheel, braking system, and capability of driving on public roads.

The Tribunal concluded the applicant was involved in an accident, but declined to order a special award against the respondent.

The plaintiff brought a motion for partial summary judgment on the issue of liability after allegedly being injured when she fell while backing away from the defendant's dog.

The court dismissed the motion, finding that there were significant factual disputes regarding whether the dog made contact with the plaintiff, whether the incident constituted an 'attack' under the Dog Owners' Liability Act, and the extent of the plaintiff's contributory negligence.

The court concluded that a trial was necessary to resolve these genuine issues.

The applicant was injured in a motor vehicle accident and sought medical benefits for a chiropractic treatment plan.

The respondent initially denied the plan but paid it after the applicant filed an appeal with the Licence Appeal Tribunal.

The applicant subsequently sought costs of the proceeding and a special award, alleging the respondent unreasonably withheld payment.

The Tribunal dismissed both claims, finding the respondent's initial denial and request for updated medical records was not unreasonable given the prior medical evidence indicating the applicant had recovered.

The Tribunal also found no evidence of unreasonable or bad faith conduct during the proceeding to justify a costs award.

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

The insurer terminated the benefits and the applicant applied for arbitration more than two years after the refusal.

The insurer requested a preliminary issues hearing to determine if the application was time-barred.

The applicant argued that the insurer was estopped from relying on the limitation period due to post-mediation settlement negotiations, and alternatively sought relief from forfeiture.

The arbitrator held that the application was out of time, finding no evidence that the insurer promised not to rely on the limitation period.

The arbitrator also held that relief from forfeiture is not available for a missed limitation period.

The claims for income replacement benefits were dismissed.

The applicant was four months pregnant when she was involved in a motor vehicle accident.

She claimed caregiver benefits for services provided to the child she was carrying, who was born after the accident.

The insurer denied the claim.

The Arbitrator held that the en ventre sa mere fiction does not apply to a claim for caregiver benefits because the benefit is not a right of the child, the scheme of the Schedule does not require a principled extension of the fiction, and the language of the legislation ousts the fiction.

The applicant was therefore precluded from receiving the weekly caregiver benefits claimed.