3 total
Application for a special award dismissed; insurer reasonably relied on contemporaneous medical assessments to adjust benefits.
The applicant, who was catastrophically impaired in a 2005 dirt bike accident, sought a special award under s. 10 of Regulation 664, alleging the respondent insurer acted in bad faith and unreasonably withheld attendant care and medical rehabilitation benefits.
The adjudicator found that the respondent reasonably relied on contemporaneous occupational therapy assessments to adjust and eventually discontinue attendant care benefits.
The applicant failed to prove what additional medical and rehabilitation benefits he ought to have received or that the respondent managed his file in bad faith.
The application was dismissed.
Appeal allowed and new trial ordered due to trial judge's failure to properly analyze negligence elements regarding a fallen tree limb.
The appellant hydro company and respondent property owner appealed a Small Claims Court decision finding them both liable in negligence for a power surge caused by a fallen tree limb that damaged the plaintiff's electrical equipment.
The Divisional Court found that the trial judge committed palpable and overriding errors by failing to determine whether the limb was dead or alive before assessing the property owner's liability, and by failing to properly analyze the hydro company's standard of care given uncontradicted evidence of its adherence to industry-standard tree inspection cycles.
The appeal and cross-appeal were allowed, and a new trial was ordered.
Motion for interim benefits granted to fund brain injury treatment pending arbitration.
The applicant, who suffered a brain injury in a motorcycle accident, brought a motion for interim benefits to cover the cost of treatment at the Anagram Treatment Centre pending arbitration.
The insurer opposed, arguing the treatment was unreasonable and the recommending psychologist was in a conflict of interest.
The arbitrator granted the motion, finding that the applicant risked significant prejudice if treatment for organic brain damage was delayed, whereas the insurer faced little risk as it could recover any overpayment from the applicant's uninsured motorist tort claim if the treatment was later found unnecessary.