92 total
Respondent's costs request denied for failing to specify the amount requested under Rule 19.3.
The applicant sought statutory accident benefits but withdrew his application after the respondent filed its submissions.
The respondent sought costs, arguing the applicant acted unreasonably and withheld information.
The Tribunal denied the costs request because it failed to specify the amount requested or the number of days of attendance, as required by Rule 19.3 of the Common Rules of Practice and Procedure.
The application was dismissed and the file closed.
Claim for catastrophic impairment assessments dismissed as the applicant failed to justify the request.
The applicant sought $16,712.81 for catastrophic impairment determination assessments following a 2013 motor vehicle accident.
The insurer denied the treatment plan, stating the recommendation did not fit the loss details.
The applicant argued the denial notice was invalid under s. 38(8) of the SABS for failing to provide meaningful medical reasons, triggering s. 38(11).
The Tribunal found the applicant failed to meet their burden of proof, noting the OCF-18 provided no explanation for the assessments or how they related to the accident.
The Tribunal held the insurer's denial was adequate and dismissed the claim for the assessment costs and interest.
Reconsideration request dismissed; no breach of procedural fairness or error of law in applying res judicata.
The applicant requested a reconsideration of a motion order that dismissed her application for accident benefits on the basis of res judicata.
The applicant argued that the Tribunal violated procedural fairness by proceeding with a written hearing instead of a videoconference, and that it erred in law and fact by failing to consider fresh evidence and whether res judicata should be waived.
The Adjudicator dismissed the request, finding no breach of procedural fairness as the applicant had a full opportunity to present her case in writing.
Furthermore, the Adjudicator found no error of law or fact, noting that the applicant was attempting to re-litigate issues already decided.
Application for statutory accident benefits dismissed; applicant failed to prove treatments were reasonable and necessary.
The applicant sought statutory accident benefits for chiropractic services, prescriptions, and catastrophic impairment assessments following a motor vehicle accident.
The Licence Appeal Tribunal found that the applicant failed to prove the proposed physical treatments were reasonable and necessary, as her limitations were primarily driven by psychological pain avoidance behaviours rather than physical impairments.
The claim for prescriptions was denied for lack of supporting documentation linking them to the accident.
The claim for additional catastrophic assessment fees was denied because file reviews are included in the $2,000 statutory cap per assessment.
The application was dismissed in its entirety.
Application for accident benefits dismissed; injuries fell within the Minor Injury Guideline and IRB criteria unmet.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent insurer determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied further medical benefits and income replacement benefits (IRB).
The Licence Appeal Tribunal found that the applicant's physical injuries were predominantly minor soft tissue injuries and that she failed to establish chronic pain or psychological injury to remove her from the MIG.
The Tribunal also dismissed the claim for IRB, finding insufficient medical evidence to establish a substantial inability to perform the essential tasks of her employment, and denied the claims for medication expenses.
Application for psychological and chiropractic accident benefits dismissed for lack of supporting medical evidence.
The applicant sought medical benefits for psychological and chiropractic services following a motor vehicle accident.
The respondent insurer denied the treatment plans.
The Licence Appeal Tribunal found that the applicant failed to prove the treatment plans were reasonable and necessary.
The psychological treatment plan lacked necessary details about the providers, and the applicant failed to provide requested information.
The chiropractic treatment plan was not supported by medical evidence, and the Tribunal preferred the evidence of the respondent's orthopaedic surgeon who found no objective signs of impairment.
The application was dismissed.
Accident benefits denied where surveillance and inconsistent evidence undermined applicant's claims of disability and income loss.
The applicant sought statutory accident benefits, including an income replacement benefit (IRB) and medical benefits, following an ebike collision.
The Licence Appeal Tribunal dismissed the application, finding the applicant's evidence regarding her pre-accident income and inability to work lacked credibility and was contradicted by surveillance evidence showing her working and riding her ebike.
The Tribunal concluded the applicant suffered predominantly minor injuries subject to the $3,500 treatment cap, which had been exhausted, and that the requested treatment plans were not reasonable or necessary.
Application for statutory accident benefits dismissed; injuries fell within the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, medical benefits for chiropractic treatment, and the cost of an attendant care assessment.
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 failed to prove his physical or psychological injuries fell outside the MIG, noting a lack of corroborating medical evidence and inconsistencies in his testimony.
Consequently, the Tribunal dismissed the claims for medical benefits and the assessment cost.
The Tribunal also dismissed the claim for a non-earner benefit, finding no evidence that accident-related impairments prevented the applicant from engaging in substantially all of his pre-accident activities.
Application for accident benefits from MVACF dismissed as the visiting applicant was not ordinarily resident in Ontario.
The applicant, a Chinese citizen visiting Ontario, was struck by an unidentified vehicle as a pedestrian and sought statutory accident benefits from the Motor Vehicle Accident Claims Fund (MVACF).
The respondent denied the claim on the basis that the applicant was not ordinarily resident in Ontario at the time of the accident, as required by section 25 of the Motor Vehicle Accident Claims Act.
The Tribunal applied the Thomson residency test and found that the applicant's stay in Ontario was not of a sufficiently permanent nature to establish ordinary residence.
The applicant was in Ontario on a visitor visa, had no Canadian income or bank account, and returned to China shortly after completing an English language course.
The application for benefits was dismissed.
Application for accident benefits dismissed; injuries fell within the Minor Injury Guideline funding limit.
The applicant was struck by a passenger-side door while walking and sought accident benefits.
The respondent determined the injuries fell within the Minor Injury Guideline (MIG) and denied a $1,553.76 chiropractic treatment plan because the $3,500 funding limit was exhausted.
The applicant argued they suffered from chronic pain and psychological injuries, which should remove them from the MIG.
The Tribunal found no compelling medical evidence or diagnosis of chronic pain or psychological injury, noting the respondent's physiatry assessment concluded the injuries were minor.
The application was dismissed, and the disputed treatment plan and interest were denied.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline.
The insurer denied certain treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant's physical and psychological injuries, including soft tissue injuries, were predominantly minor and did not remove her from the MIG.
The Tribunal also rejected the applicant's claim of chronic pain syndrome, noting a lack of supporting medical evidence and functional impairment.
As the injuries fell within the MIG, the treatment plans were not payable and the application was dismissed.
Amendment denied because the proposed claim was out of time.
The plaintiff moved for leave to amend a slip and fall statement of claim to add two additional defendants allegedly involved in snow removal at the premises.
The motion turned on whether the claim against the proposed defendants was discovered, or reasonably discoverable, more than two years before service of the amendment motion.
The court held that even on the most generous view of discoverability, the limitation period expired before the motion was served.
Section 21(2) of the Limitations Act, 2002 barred the addition of the proposed defendants, and the motion was dismissed.