Tricia McAvoy

The applicant was injured in a motor vehicle accident and received income replacement benefits until they were terminated by the insurer.

The applicant sought further income replacement benefits, arguing he was unable to return to his pre-accident employment as a concrete cutter due to physical and psychological impairments.

The arbitrator found the applicant's physical impairment evidence unreliable, but accepted the psychological evidence that he suffered from major depressive disorder and anxiety which prevented him from working.

The arbitrator preferred the applicant's psychological expert over the insurer's expert.

The applicant was awarded income replacement benefits for the disputed period.

Claims for attendant care and housekeeping were withdrawn, and a claim for the cost of a functional abilities evaluation was denied for failing to seek prior approval.

The applicant was injured in a motor vehicle accident and applied for non-earner benefits.

The insurer denied the claim.

At arbitration, the adjudicator found that the applicant did not suffer a complete inability to carry on a normal life as a result of the accident.

While her life changed post-accident, she continued to engage in substantially all of her pre-accident activities, particularly her religious activities, and her reduced functioning was largely attributable to marital breakdown rather than the accident.

The application for non-earner benefits and interest was dismissed.

The applicant was driving his car when concrete debris fell from a building and struck his vehicle, causing him to hit his head on the roof.

The insurer denied statutory accident benefits, arguing the incident was not an 'accident' under the Schedule because the falling debris was an intervening act.

The arbitrator held that the incident met the definition of an accident, finding that falling debris is a normal incident of the risk created by the use or operation of an automobile, similar to road hazards, and not an intervening act like an assault.

The preliminary issue was resolved in favour of the applicant.

The insurer brought a motion to stay the arbitration pending the applicant's attendance at a psychiatric insurer's medical examination (IME).

The applicant had previously attended a psychological IME arranged by the insurer, which concluded she suffered a complete inability to work due to depression but could not isolate the accident as the primary cause.

The insurer sought a further psychiatric IME to address causation.

The arbitrator dismissed the motion, finding the insurer had already been afforded a fair opportunity to evaluate the applicant's condition and failed to establish that the additional psychiatric assessment was reasonably necessary.

The applicant was awarded her legal expenses for the motion.

The appellants, Ontario residents, were injured during an excursion tour while vacationing in Costa Rica.

They brought an action in Ontario against several defendants, including the Costa Rican company that sold the excursion.

The Costa Rican company successfully moved to stay the action on the basis that Ontario courts lacked jurisdiction and, alternatively, that Costa Rica was the more convenient forum.

The Court of Appeal applied the real and substantial connection test and the principles of order and fairness, concluding that the Ontario courts could not assume jurisdiction over the foreign defendant.

The appeal was dismissed.

The applicant was injured in a motor vehicle accident one week after starting a new job as a superintendent.

She applied for income replacement benefits.

The insurer calculated her benefits based only on the $308 she earned in the four weeks preceding the accident, resulting in a weekly benefit of $59.69.

The applicant argued her benefits should be extrapolated to reflect her annual salary of $16,000.

The arbitrator held that under the Statutory Accident Benefits Schedule, the income must be based on the amount actually earned in the four weeks prior to the accident, confirming the $59.69 weekly benefit.

The issues of repayment of caregiver benefits and expenses were adjourned for an evidentiary hearing.

The applicant was injured in a motor vehicle accident and received statutory accident benefits.

The insurer terminated benefits and requested the applicant attend a psycho-vocational assessment.

The applicant refused, arguing it was not an examination by a qualified medical practitioner and was not reasonably required.

The arbitrator found that the proposed assessment was predominantly vocational rather than medical, and therefore did not meet the requirements of section 23(2) of the Schedule.

Furthermore, given the extensive medical evidence already available and the lack of change in the applicant's condition, the request was not reasonable.

The applicant was not precluded from proceeding to arbitration.