Ryan St. Aubin

The applicant sought statutory accident benefits after being assaulted and carjacked while backing her vehicle out of a parking space.

The respondent denied benefits on the basis that the incident did not meet the definition of an 'accident' under s. 3(1) of the Schedule.

The Tribunal found that while the incident met the purpose test, it failed the causation test.

The physical assault by the third party was an intervening act that severed the chain of causation, and the use or operation of the vehicle was not the direct cause of the applicant's impairments.

The application was dismissed.

The applicant was injured while a passenger on a TTC bus and sought statutory accident benefits.

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

The Tribunal found that the applicant did not provide notice within the prescribed timeline and failed to establish a reasonable explanation for the delay under section 34.

Consequently, the applicant was statute-barred from proceeding with his application.

The applicant was a passenger on a public transit bus involved in an accident and sought statutory accident benefits.

She failed to notify the respondent of her intention to apply for benefits within the seven-day period prescribed by s. 32(1) of the Schedule, waiting over four months to do so.

The Tribunal found that the applicant did not provide a reasonable explanation for the delay under s. 34, noting she had access to legal counsel and was familiar with the accident benefits process from a prior claim.

Consequently, the applicant was statute-barred from proceeding with her application under s. 55(1) of the Schedule, and the application was dismissed.

The applicant sought an income replacement benefit (IRB) and an award for unreasonable delay following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to establish the essential tasks of his pre-accident employment and did not prove a substantial inability to perform those tasks within the first 104 weeks.

Furthermore, the applicant failed to demonstrate a complete inability to engage in any suitable employment after 104 weeks.

The claim for an award was also dismissed as the applicant provided no evidence or arguments to support it.

The applicant sought a determination that she sustained a catastrophic impairment under s. 3.1(1)8 of the Statutory Accident Benefits Schedule following a motor vehicle accident.

The parties agreed the applicant had a Class 3 impairment in activities of daily living and a Class 4 impairment in adaptation.

The dispute centered on whether she had Class 4 impairments in social functioning and concentration, persistence, and pace.

The Tribunal preferred the respondent's psychiatric evidence, finding the applicant maintained close family relationships and could sustain focus for daily tasks.

The Tribunal concluded the applicant suffered only Class 3 impairments in the disputed spheres and therefore did not meet the criteria for catastrophic impairment.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, including attendant care and various medical and rehabilitation benefits.

The respondent denied the benefits, and the applicant applied to the Licence Appeal Tribunal.

The Tribunal found that the applicant was not entitled to ongoing attendant care benefits, as the medical evidence demonstrated he was mostly independent in his activities of daily living and failed to prove the expenses were incurred.

The Tribunal granted one physiotherapy treatment plan for $4,022.42, finding it reasonable and necessary for pain reduction, despite the respondent's argument that the injuries fell within the Minor Injury Guideline.

The remaining claims for further treatment, assessments, and treatment provider mileage were dismissed as they were either duplicative, not reasonable and necessary, or not payable under the Schedule.

The applicant sought medical, income replacement, and attendant care benefits following a rear-end motor vehicle accident.

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

The Licence Appeal Tribunal found that the applicant sustained predominantly soft tissue injuries, which are defined as minor injuries under the Schedule.

Consequently, the applicant was not entitled to the disputed medical benefits or attendant care benefits.

The claim for income replacement benefits was also dismissed, as the applicant failed to prove a substantial inability to perform his pre-accident employment tasks, and his tax returns showed his income increased after the accident.

The plaintiffs brought a motion to approve a settlement on behalf of Sheila Clarke, a person under disability, arising from a slip and fall incident.

The motion was dismissed without prejudice due to numerous deficiencies in the supporting materials.

The court found issues with redactions without justification, absence of minutes of settlement, lack of medical information and assessment of damages, insufficient liability assessment, and deficient affidavits from both the lawyer and the litigation guardian.

Furthermore, the court noted a lack of detailed evidence regarding legal fees and disbursements, including a contingency fee agreement.

The applicant was involved in a motor vehicle accident and sought various statutory accident benefits from the respondent, including income replacement, medical rehabilitation, and other expenses.

The parties attended a videoconference hearing before the Licence Appeal Tribunal.

At the hearing, the parties settled the issues in dispute on a full and final basis.

The Tribunal closed the file, noting that either party could request to re-open it if the settlement fell through.

The respondent brought a motion to dismiss the applicant's claim for statutory accident benefits due to her failure to attend an insurer's examination (IE), or alternatively, for a stay of proceedings.

The Tribunal denied the motion to dismiss, finding that barring the application would be unduly prejudicial and contrary to procedural fairness.

However, the Tribunal granted a 120-day stay of proceedings to allow the respondent to schedule and complete the required physiatry IE, as the applicant agreed to attend.

The applicant's request for costs was denied.

The applicant, who was 11 years old at the time of the motor vehicle accident, sought various medical and rehabilitation benefits outside the Minor Injury Guideline.

The adjudicator found that the applicant established entitlement to a treatment plan for physiotherapy and chiropractic services, as they were reasonable and necessary as a result of the accident.

However, the remaining benefits for occupational therapy and psychological assessments were denied because they either exceeded the maximum amount payable for an assessment or were not supported by objective medical evidence from qualified practitioners.

Both parties requested reconsideration of a decision regarding statutory accident benefits for chiropractic treatment.

The applicant sought to introduce new evidence to approve a denied treatment plan, which the Tribunal rejected as the evidence could have been obtained previously.

The respondent argued the adjudicator erred in approving two treatment plans based solely on pain complaints without evidence of functional improvement or actual pain reduction.

The Tribunal agreed with the respondent, finding a significant error of law and fact in the original decision.

The applicant's request was dismissed, the respondent's request was granted, and all three treatment plans were deemed not reasonable and necessary.

The applicant, a pedestrian struck by a taxi, sought various statutory accident benefits from the Motor Vehicle Accident Claims Fund.

The Tribunal found the applicant was removed from the Minor Injury Guideline due to a psychological impairment.

Claims for two psychological treatment plans were denied because the applicant failed to sign them as required by s. 38(3)(a) of the Schedule.

The Tribunal approved the balance of a third psychological treatment plan and two chiropractic treatment plans, finding them reasonable and necessary.

A claim for the balance of a neuropsychological assessment was denied as it exceeded the $2,000 cap under s. 25(1)(5).

Claims for prescription medications were partially approved.

The respondent's request for costs was dismissed.

The applicant sought statutory accident benefits for chiropractic treatment following a motor vehicle accident.

The respondent denied the treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been exhausted.

The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that her injuries were not predominantly minor or that she had a pre-existing condition preventing maximal recovery within the MIG limits.

The application was dismissed.