Sareena Harpreet Samra

The applicant sought statutory accident benefits following a motor vehicle accident.

The Licence Appeal Tribunal found the applicant was barred from receiving income replacement benefits because she was driving with a suspended licence at the time of the accident, which constitutes driving without a valid licence under s. 31(1)(a)(ii) of the Schedule.

Consequently, the insurer was entitled to repayment of $9,483.76 in previously paid benefits.

The Tribunal also dismissed the applicant's claims for various medical and rehabilitation benefits, finding she failed to prove the proposed treatments were reasonable and necessary.

The applicant sought various medical, rehabilitation, and attendant care benefits following a motor vehicle accident.

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

The Tribunal found that the applicant was entitled to some of the proposed psychological, physiotherapy, and chiropractic treatment plans, primarily for the completion of OCF-18 forms and where contemporaneous medical evidence supported the need for treatment.

However, the Tribunal dismissed the claims for attendant care benefits, medication expenses, and several other treatment plans due to a lack of supporting evidence.

The request for a special award under s. 10 of Reg. 664 was also dismissed, as the applicant failed to prove the respondent acted unreasonably.

The applicant was injured in a motor vehicle accident and sought $4,520.00 for catastrophic impairment assessments, representing the denied portion of a treatment plan.

The respondent had approved $10,230.81 for the assessments but denied the $2,000.00 fee for each medical professional to conduct a clinical file review assessment, arguing it exceeded the $2,000.00 cap per assessment under section 25(5)(a) of the Schedule.

The Tribunal agreed with the respondent, finding that a file review is part of the assessment expense and is included within the $2,000.00 limit.

The application was dismissed, and no interest was awarded.

The applicant sought statutory accident benefits from the Motor Vehicle Accident Claims Fund following a motor vehicle accident.

The Fund denied benefits on the basis that the applicant was not ordinarily resident in Ontario at the time of the accident, pursuant to s. 25(1) of the Motor Vehicle Accident Claims Act.

The Tribunal found that the applicant, a citizen of China and a refugee protection claimant subject to a conditional removal order, had temporary ties to Ontario and failed to produce material evidence regarding his immigration status.

The Tribunal concluded the applicant was not ordinarily resident in Ontario and dismissed the application.

Puri Professional Corporation (Puri PC) sought coverage under an errors and omissions insurance policy from Lloyd’s Underwriters and The Sovereign General Insurance Company (the Insurers) for a client's negligence claim related to tax advice.

The Insurers moved for summary judgment to dismiss Puri PC's claim, arguing the alleged wrongful acts occurred before the policy's retroactive date.

Puri PC brought a cross-motion for summary judgment, seeking a declaration of coverage, arguing a clerical error in the application should be rectified.

The court granted the Insurers' motion for summary judgment, dismissing Puri PC's claim, finding the retroactive date exclusion clearly applied and rectification was not warranted as the alleged acts occurred well before the policy's retroactive date.

The applicant sought entitlement to statutory accident benefits following a motor vehicle accident, specifically claiming costs for physiotherapy, psychological services, and a multi-disciplinary catastrophic impairment assessment.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to provide sufficient medical evidence or submissions to prove the treatment plans were reasonable and necessary.

The Tribunal preferred the respondent's psychological assessment, which concluded the applicant had reached maximum recovery, over the applicant's evidence.

Claims for interest and an award for unreasonable delay were also dismissed.

The defendant, Lloyd's Underwriters, brought a motion for summary judgment to dismiss an action by the plaintiff, 2689686 Ontario Inc., concerning a roof collapse at a property insured under a Builder's Risk policy.

The court found that the loss was caused by frost and heaving, a peril explicitly excluded by the policy.

The plaintiff failed to provide sufficient evidence to counter the defendant's expert opinion or establish an exception to the exclusion.

Consequently, the court granted summary judgment, dismissing the action against Lloyd's Underwriters.

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits for an in-home assessment and catastrophic impairment assessments.

The insurer denied the benefits.

The Licence Appeal Tribunal found that the applicant failed to meet her burden of proving the treatment plans were reasonable and necessary.

The applicant did not provide sufficient contemporaneous medical evidence, failed to address causation issues related to subsequent accidents, and did not submit the disputed catastrophic impairment assessment plan or explain the disputed amounts.

The application was dismissed, and claims for interest and an award were consequently denied.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit was exhausted.

The applicant argued for removal from the MIG based on chronic pain and psychological impairments.

The Tribunal found insufficient evidence of chronic pain, noting the lack of a diagnosis or evidence meeting the AMA Guides criteria.

The Tribunal also gave no weight to the applicant's psychological assessment, as it was conducted by a social worker rather than the signing psychologist.

Relying on the respondent's section 44 assessments, the Tribunal concluded the applicant did not suffer a clinically significant psychological impairment.

The application was dismissed, and claims for treatment plans, an award, and interest were denied.

The applicant, a pedestrian struck by a vehicle, sought non-earner benefits and a medical benefit for physiotherapy from her insurer.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to demonstrate a complete inability to carry on a normal life as required for non-earner benefits.

The Tribunal also found the physiotherapy treatment plan was not reasonable and necessary, noting a lack of contemporaneous medical evidence supporting the need for treatment.

Claims for interest and a special award were consequently dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of two physiotherapy treatment plans and a portion of a psychological treatment plan.

The respondent argued the applicant was barred from proceeding with one physiotherapy claim due to non-attendance at an insurer's examination, but the Tribunal found no prejudice as the applicant attended a subsequent examination.

On the merits, the Tribunal dismissed the application, finding the physiotherapy plans were not proven reasonable and necessary given the lack of objective medical evidence and an unopposed independent medical examination.

The Tribunal also upheld the respondent's reduced hourly rate for the psychological services provided by an unregulated social worker.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing her injuries fell outside the Minor Injury Guideline (MIG) due to chronic pain and psychological impairment.

The Tribunal found insufficient medical evidence of functional impairment arising from chronic pain, noting the applicant returned to work shortly after the accident.

The Tribunal also gave little weight to a psychological report prepared nearly two years post-accident due to a lack of corroborating evidence.

The application was dismissed, and the applicant remained subject to the MIG limits.

The applicant sought income replacement benefits following a motor vehicle accident.

The respondent denied the benefits and raised a preliminary issue that the applicant was statute-barred from claiming pre-104 benefits due to her failure to attend section 44 insurer examinations.

The Tribunal agreed, finding the applicant failed to attend properly scheduled examinations without a reasonable explanation.

Regarding post-104 benefits, the Tribunal found the applicant did not suffer a complete inability to engage in employment, noting she had returned to work and closed her business due to pandemic lockdowns rather than accident-related impairments.

The claims for benefits, interest, and an award were dismissed.

The applicant sought statutory accident benefits for physiotherapy, chiropractic services, psychological treatment, and prescription medications following a motor vehicle accident.

The respondent insurer denied the benefits.

The Licence Appeal Tribunal found that the applicant failed to meet his burden of proving the treatment plans and medication expenses were reasonable and necessary.

The Tribunal preferred the respondent's medical evidence, which indicated the applicant sustained soft-tissue injuries and had achieved maximum medical recovery.

The application was dismissed in its entirety, including claims for interest and a special award.

The applicant sought entitlement to a $2,200 psychological assessment, a special award, and interest following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the treatment plan was not reasonable and necessary.

The Tribunal rejected the applicant's psychological evidence, noting it relied on self-reporting that was contradicted by surveillance footage showing the applicant driving frequently and engaging in various activities.

The Tribunal accepted the respondent's insurer examination, which found no psychological symptoms warranting further investigation.

The respondent insurer requested a reconsideration of a decision awarding the applicant a non-earner benefit for a three-month period due to the insurer's failure to comply with its procedural obligations under s. 36(4) of the Schedule.

The insurer argued the Tribunal erred in law by awarding the benefit despite finding the applicant did not meet the substantive entitlement test, and breached procedural fairness by ignoring alleged misrepresentation.

The Tribunal dismissed the request, finding the insurer was attempting to relitigate issues and raise new legal arguments and allegations of misrepresentation that were not properly before the Tribunal at the initial hearing.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, psychological services, an occupational therapy assessment, and out-of-pocket expenses.

The Tribunal found that the applicant was not entitled to the non-earner benefit because she failed to provide sufficient evidence comparing her pre- and post-accident activities to establish a complete inability to carry on a normal life.

The Tribunal also denied the psychological treatment plans because the applicant failed to justify the service providers charging rates higher than those prescribed for psychotherapists in the Professional Services Guideline, and failed to justify transportation costs.

The requests for an occupational therapy assessment, a massage chair, and a flight cancellation fee were also dismissed as not reasonable and necessary or not payable under the Schedule.

Claims for an award and interest were dismissed.

The applicant sought a catastrophic impairment designation and a treatment plan for physiotherapy following a 2017 motor vehicle accident.

The respondent argued the application was an abuse of process because the Tribunal had previously dismissed a similar application by the applicant, finding her evidence unreliable and her impairments not linked to the accident.

The Tribunal agreed, finding that allowing the application to proceed on largely identical evidence would undermine the integrity of the adjudicative process.

The applicant failed to provide new evidence demonstrating a material change in her condition.

The application was dismissed as an abuse of process.

The applicant requested a reconsideration of a previous Licence Appeal Tribunal decision which found her injuries were subject to the Minor Injury Guideline (MIG) and denied her claimed benefits.

The applicant argued the Tribunal erred by failing to shift the burden of proof to the respondent, misinterpreting a gap in her medical records, and failing to find the insurer's denial invalid.

The Tribunal dismissed the request, holding that the burden of proof always rests on the applicant.

While acknowledging a potential minor error regarding the medical records gap, the Tribunal found it would not have changed the outcome due to insufficient evidence linking her impairments to the accident.

The Tribunal also rejected the argument regarding the invalid denial due to a lack of specific submissions.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming funding for psychological services and a catastrophic impairment assessment.

The respondent denied the claims on the basis that they were not reasonable and necessary.

The Tribunal found that the respondent provided sufficient medical reasons for its denials and complied with the notice requirements under the Schedule.

The Tribunal concluded that the applicant failed to meet his evidentiary burden to prove the treatments and assessments were reasonable and necessary, particularly given the lack of response to prior psychological treatment and the absence of evidence supporting a neurological impairment.

The application was dismissed.