111 total
Insurer must pay accident benefits as passenger reasonably believed unlicensed driver had owner's implied consent.
The applicant was injured as a passenger in a single-vehicle accident.
The vehicle was owned by the applicant's father and driven by the applicant's friend, who was unlicensed and had been drinking.
The respondent insurer denied the applicant's claim for statutory accident benefits, arguing that the applicant knew or ought reasonably to have known that the driver was operating the vehicle without the owner's consent, triggering the exclusion under s. 31(1)(c) of the Schedule.
The Tribunal found that the owner had given the applicant broad, unrestricted permission to allow others to drive, establishing implied consent.
Furthermore, the Tribunal held that an ordinary person in the applicant's position would have reasonably believed the driver had consent.
The exclusion did not apply, and the respondent was ordered to pay the disputed benefits.
Claims for a special award and costs were dismissed.
The court issued a case management timetable for five consolidated actions arising from a multi-vehicle collision.
This endorsement outlines a case management order for five consolidated actions arising from a motor vehicle accident.
The court, acting as case management judge, set a timetable for the remaining procedural steps, including the completion of examinations for discovery, answering undertakings, conducting defence medical examinations, and scheduling a mediation.
The order also directed counsel to circulate a draft consent order for trial of the actions together and to advise on the continuation of an action against a specific insurer.
The court fixed partial indemnity costs at $2,995, payable upon final resolution of the action.
This costs endorsement followed a successful motion by the defendant regarding discovery issues.
The defendant sought costs on a partial indemnity basis, initially claiming $3,816.92.
The plaintiff argued for nil costs, citing unfairness due to a late-served affidavit and the defendant's partial lack of success on one question, and also requested delayed payment due to a SABS settlement.
The court rejected the plaintiff's arguments for nil costs, finding the defendant's late affidavit was properly admitted.
The court adjusted the defendant's claimed fees due to redacted dockets and reduced the student's hourly rate, ultimately fixing costs at $2,995.
The court also upheld the original decision for delayed payment of costs until the final resolution of the action, noting that the costs would bear interest.
Insurer's request for reconsideration dismissed; prior settlement release was limited to specific FSCO claims.
The respondent insurer requested a reconsideration of a decision ordering payment of a $2,106 treatment plan for physiotherapy services.
The insurer argued the Adjudicator erred in interpreting a Partial Release signed in a related FSCO matter as not barring the LAT claim.
The Vice-Chair dismissed the request, finding the Partial Release clearly limited the settlement to past claims that were the subject matter of the FSCO file, and the insurer failed to establish a significant error of law or fact.
Production of subsequent accident benefits file ordered subject to redactions; request for EI and bank records denied.
The respondent insurer brought a motion for the production of the applicant's accident benefits file from a subsequent motor vehicle accident, as well as the applicant's Employment Insurance file and bank statements.
The Tribunal granted the motion in part, ordering the production of the subsequent accident benefits file subject to redactions for relevance and privilege, as it was relevant to assessing the applicant's ongoing impairments and causation.
The Tribunal dismissed the request for the EI file and bank statements, finding them irrelevant, highly intrusive, and obtainable through other means.
Applicant awarded all disputed statutory accident benefits and assessments as reasonable and necessary.
The applicant sought various statutory accident benefits following a motor vehicle accident, including an assessment of attendant care needs, psychological services, chiropractic services, physiotherapy services, and a multidisciplinary assessment.
The respondent denied these claims based primarily on insurer examinations.
The adjudicator found the applicant's medical evidence more persuasive, noting ongoing pain and functional impairments.
The adjudicator concluded that all requested treatment plans and assessments were reasonable and necessary, and awarded interest on all overdue payments.
The Court upheld the civil forfeiture of a motorcycle clubhouse and associated paraphernalia.
The Attorney General of Ontario appealed a Superior Court decision ordering civil forfeiture of a property located at 855 Darby Road, Welland, and associated Hells Angels Motorcycle Club paraphernalia under the Civil Remedies Act, 2001.
The property was owned by members of the HAMC and used as a clubhouse.
The Crown established that mortgage payments were funded in part by dues paid by HAMC members engaged in drug trafficking, and that the property was used as a meeting place where criminal activity was planned.
The Court of Appeal upheld the forfeiture order, finding the property constituted both proceeds and an instrument of unlawful activity, and that the legitimate owner and responsible owner exceptions did not apply.
Claims for income replacement and medical benefits dismissed as applicant failed to prove accident-related impairments.
The applicant was struck by a vehicle while crossing a street and sought income replacement benefits (IRBs) and medical benefits from her insurer.
The insurer terminated IRBs and denied further medical benefits.
At arbitration, the applicant claimed physical and psychological impairments, relying on a multi-disciplinary assessment.
The arbitrator rejected the applicant's expert psychological evidence, noting the assessors had little to no contact with the applicant and their conclusions were inconsistent with her failure to seek psychological treatment and her academic achievements post-accident.
Finding no physical or psychological impairments caused by the accident, the arbitrator dismissed the claims for IRBs, medical benefits, and a special award.
Insurer awarded $10,955.87 in expenses after successfully defending all issues in accident benefits arbitration.
Following an arbitration where the insurer successfully defended all claims for statutory accident benefits, the parties could not agree on expenses.
The insurer sought $39,474.46 in expenses.
The arbitrator found the insurer was entitled to expenses based on its complete success.
Applying a broad-strokes approach and a 2:1 ratio of preparation to hearing time, the arbitrator reduced the claimed amounts and awarded the insurer $10,955.87 inclusive of fees, disbursements, and HST.
Appeal allowed and fresh hearing ordered because the Arbitrator failed to provide adequate reasons.
The appellant appealed an Arbitrator's decision dismissing her claims for post-104 week income replacement benefits and a medical benefit for a physiotherapy treatment plan.
The Director's Delegate found that the Arbitrator failed to provide adequate reasons for his decision, which constituted a breach of natural justice and procedural fairness.
The Arbitrator ignored, failed to summarize, analyze, or consider important evidence that was not supportive of the insurer's position, and misinterpreted other evidence.
The appeal was allowed, the decision rescinded, and the matter returned to arbitration for a fresh hearing before a different arbitrator.
Tribunal awards chronic pain assessment but denies further attendant care benefits and orthopaedic assessment.
The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to attendant care benefits and the costs of chronic pain and orthopaedic assessments.
The Tribunal found that the applicant was not entitled to further attendant care benefits beyond what the respondent had already paid, as the services were no longer reasonable or necessary after January 15, 2015.
The Tribunal approved the chronic pain assessment, finding it reasonable and necessary given the applicant's ongoing pain and psychological injuries.
However, the orthopaedic assessment was denied as unnecessary, since the applicant's physical injuries were already well-documented and the chronic pain assessment would sufficiently address the ongoing issues.
Appeal allowed and fresh hearing ordered because arbitrator failed to provide adequate reasons and ignored evidence.
The appellant appealed an arbitrator's decision dismissing her claims for post-104 week income replacement benefits and a medical benefit for a physiotherapy treatment plan.
The Director's Delegate allowed the appeal, finding that the arbitrator failed to provide adequate reasons for his decision and failed to fairly consider the evidence from both parties.
The arbitrator ignored or misinterpreted significant evidence from several experts, including those retained by the insurer, whose opinions supported the appellant's claims.
The matter was returned to arbitration for a fresh hearing before a different arbitrator.
Application for medical benefits dismissed as impairments were caused by pre-existing conditions, not the accident.
The applicant sought medical benefits for treatments following a motor vehicle accident.
The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the accident caused her impairments, which were consistent with her pre-existing arthritic and fibromyalgia conditions.
The Tribunal also rejected the applicant's procedural argument that the insurer failed to provide timely notice of its refusal to pay, finding the insurer complied with the ten-day notice requirement under the Statutory Accident Benefits Schedule.
Clubhouse and official paraphernalia forfeited to the Crown as instruments and proceeds of unlawful activity.
The Attorney General of Ontario applied for civil forfeiture of a property used as a Hells Angels clubhouse and various Hells Angels paraphernalia under the Civil Remedies Act.
The court found the property was both an instrument of unlawful activity, as it was used as a safe haven to plan crimes, and proceeds of unlawful activity, as its mortgage was paid using dues funded by criminal acts.
The court also found that official Hells Angels paraphernalia were instruments of unlawful activity used for intimidation.
The owners failed to establish the responsible or legitimate owner exceptions.
The court rejected arguments that a prior federal plea bargain rendered the provincial forfeiture clearly not in the interests of justice, and ordered forfeiture of the property and official paraphernalia, along with costs against the owners.
Applications for accident benefits dismissed due to applicants' failure to attend independent medical examinations.
The applicants, adult children of a woman seriously injured in a motor vehicle accident, sought payment for social worker assessments under the Statutory Accident Benefits Schedule.
The insurer denied the treatment plans and requested independent medical examinations, which the applicants failed to attend.
The Tribunal held that the insurer was not automatically required to pay for the assessments under s. 38(11) because they were incurred outside the applicable time period.
Furthermore, the Tribunal dismissed the applications pursuant to s. 55(1) of the Schedule because the applicants failed to attend the required independent medical examinations.
Accident benefits settlement voided because the insured lacked capacity due to an acute psychotic episode.
The Applicant was injured in a motor vehicle accident and subsequently entered into a settlement agreement for statutory accident benefits.
Years later, his litigation guardian challenged the settlement, arguing either that the Applicant's father forged his signature or that the Applicant lacked capacity to contract.
The Arbitrator found that the Applicant likely signed the documents himself.
However, relying on extensive medical records showing the Applicant was involuntarily hospitalized for psychosis hours after signing, and an uncontradicted capacity assessment, the Arbitrator concluded the Applicant lacked capacity to contract both when signing and during the statutory cooling-off period.
The settlement was therefore declared not binding.
Application for post-104 week income replacement and medical benefits dismissed for failing to meet statutory tests.
The Applicant was injured in a motor vehicle accident and sought statutory accident benefits, including an Income Replacement Benefit (IRB) beyond the 104-week mark and a Medical Treatment Plan.
The Insurer denied the benefits.
The Arbitrator found that the Applicant did not meet the "complete inability" test required for post-104 week IRBs, noting her history of working in a sedentary position and the availability of suitable alternative employment that would provide a higher income than her pre-accident earnings.
The Arbitrator also dismissed the claim for the Medical Treatment Plan, finding that the Applicant failed to prove it was reasonable and necessary, and did not contradict the Insurer's medical evidence that she had reached maximum therapeutic benefit.
The application was dismissed.
Applicant awarded Income Replacement Benefit based on alternative proof of employment income; Special Award denied.
The applicant was injured in a motor vehicle accident and sought an Income Replacement Benefit (IRB) from the insurer.
The insurer conceded the medical tests for the IRB but disputed the applicant's proof of employment and income, as the applicant had not received T4s, Records of Employment, or pay stubs from his former employer.
The arbitrator found that the applicant provided a reasonable explanation for failing to call his former employer as a witness and declined to draw an adverse inference.
Relying on time sheets, uncashed cheques, text messages, and the applicant's testimony, the arbitrator concluded on a balance of probabilities that the applicant was employed at the time of the accident with an expected income of $2,000 per month.
The arbitrator ordered the payment of an IRB based on a gross weekly income of $461.54, plus interest, but denied the applicant's claim for a Special Award, finding the insurer's actions in waiting for the arbitration decision were reasonable.
Appeal transferred to Divisional Court as judgment contained no declaratory relief regarding the statutory threshold.
The appellant appealed a trial judgment dismissing his personal injury action following a motor vehicle accident.
The trial judge had found the appellant failed to prove his injuries or causation, making it unnecessary to determine the statutory threshold under the Insurance Act.
The Court of Appeal raised the issue of jurisdiction on its own motion and concluded that, because the judgment contained no declaratory relief regarding the threshold, the appeal and cross-appeal properly lay to the Divisional Court under s. 19(1.2) of the Courts of Justice Act.
The proceedings were transferred accordingly.
Successful defendant deprived of $100,000 in costs due to counsel's uncivil conduct and ignoring court orders.
The plaintiff's motor vehicle accident action was dismissed after failing to meet the statutory threshold, despite a jury awarding $30,000 in general damages.
Both parties sought costs.
The court found that the defendant's counsel engaged in uncivil conduct, failed to cooperate on a joint document brief, delivered late expert reports, and repeatedly ignored a trial management order and court deadlines.
Although the defendant was the successful party and would normally be entitled to costs of approximately $100,000, the court exercised its discretion to deprive the defendant of costs due to counsel's misconduct.
The defendant was ordered to pay $441.13 for half the copying costs of the joint document brief.