11 total
Catastrophic impairment claim dismissed; mental and behavioural impairments did not reach the marked level.
The applicant sought a determination that she sustained a catastrophic impairment due to a mental or behavioural disorder following a motor vehicle accident.
The adjudicator found that the applicant's pre-existing physical and cognitive conditions, including brain lesions and diabetes, were the primary cause of her functional limitations.
The adjudicator rejected the applicant's psychiatric expert evidence, finding it overstated her pre-accident functioning and improperly conflated physical and mental impairments.
The application was dismissed, as the applicant failed to demonstrate a marked impairment in three or more domains of function.
Slip and fall after closing vehicle trunk does not constitute an accident for statutory benefits.
The applicant sought statutory accident benefits after slipping and falling in a parking lot shortly after retrieving items from the trunk of their vehicle.
The respondent insurer denied the claim, arguing the incident did not meet the definition of an 'accident' under the Statutory Accident Benefits Schedule.
The Licence Appeal Tribunal applied the purpose and direct cause tests, finding that the applicant's use of the vehicle had ended when the trunk was closed and the fall occurred during a new task of walking away.
The application was dismissed.
Reconsideration of order denying production of photographs dismissed; moving party failed to establish relevance.
The respondent insurer sought reconsideration of a case conference order denying its request for the production of photographs taken by the applicant after a slip and fall incident.
The insurer argued the adjudicator erred by refusing to order production of a relevant document.
The Vice-Chair denied the reconsideration request, finding that the insurer failed to demonstrate how the photographs were relevant or material to determining whether the incident constituted an accident under the Statutory Accident Benefits Schedule.
Claims for psychological services and assistive devices dismissed for failing to prove reasonableness and necessity.
The applicant was injured in a motor vehicle accident and sought payment for two treatment plans under the Statutory Accident Benefits Schedule: $3,558.72 for psychological services and $2,772.32 for assistive devices.
The Licence Appeal Tribunal dismissed both claims.
The Tribunal found the applicant failed to prove the psychological services were reasonable and necessary, preferring the respondent's independent examination report.
The claim for assistive devices was also dismissed as the applicant failed to prove the disputed amount was reasonable and necessary beyond the modified amount already paid by the respondent.
City found liable for slip and fall on ice, but plaintiff held 50% contributorily negligent.
The plaintiff slipped and fell on a patch of ice in Nathan Phillips Square, suffering a fractured leg.
He sued the City of Toronto for damages under the Occupiers' Liability Act.
The court found that the City breached its duty of care by failing to identify and remove the unsafe ice patch in a high-traffic area.
However, the court also found the plaintiff 50% contributorily negligent for failing to keep a proper lookout.
General damages were assessed at $45,000, subject to the 50% reduction.
Applicant ordered to personally seek production of third-party employment records rather than merely providing authorizations.
The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.
During a pre-hearing discussion, a dispute arose regarding the production of the applicant's employment files from third-party employers.
The insurer sought production of these files, while the applicant argued that providing signed authorizations was sufficient compliance.
The arbitrator held that there is no strict rule regarding how third-party documents must be obtained, but based on the circumstances, the applicant was in a better position to obtain the documents and had a greater incentive to do so.
The arbitrator ordered the applicant to seek production of the employment files himself, with the insurer paying the third-party disbursement costs.
Arbitration dismissed as vexatious and counsel removed from record after applicant repeatedly failed to attend hearings.
After mediation failed, he applied for arbitration.
The applicant subsequently failed to attend two pre-hearings and a motion hearing, and failed to provide instructions to his counsel.
The applicant's counsel brought a motion to be removed from the record, and the insurer brought a motion to dismiss the arbitration as frivolous and vexatious.
The arbitrator granted counsel's motion to withdraw due to a breakdown in the solicitor-client relationship.
The arbitrator also dismissed the arbitration, finding that the applicant's complete failure to participate rendered the proceeding vexatious.
The applicant was ordered to pay $1,000 in costs to the insurer.
Arbitration dismissed as vexatious after applicant repeatedly failed to attend hearings or instruct counsel.
After mediation failed, the applicant applied for arbitration but subsequently failed to attend two pre-hearings and a motion hearing.
The applicant's counsel brought a motion to be removed as solicitors of record due to a breakdown in the solicitor-client relationship, which the arbitrator granted.
The insurer brought a motion to dismiss the arbitration as frivolous and vexatious.
The arbitrator granted the insurer's motion, finding that while the application may have initially had merit, the applicant's complete failure to participate rendered the proceeding vexatious.
The arbitration was dismissed and costs of $1,000 were awarded to the insurer.
Arbitration dismissed as vexatious after applicant failed to participate or attend hearings.
After mediation failed, she applied for arbitration.
The applicant subsequently failed to attend a pre-hearing or provide instructions to her counsel.
Her counsel brought a motion to be removed from the record, and the insurer brought a motion to dismiss the arbitration as frivolous and vexatious.
The applicant failed to attend the motion hearing despite receiving notice.
The arbitrator granted counsel's motion to withdraw and dismissed the arbitration, finding that the applicant's complete failure to participate rendered the proceeding vexatious.
The applicant was ordered to pay $1,000 in costs.
Appeal of interim expenses award dismissed; arbitrator entitled to enforce meaningful participation at pre-hearing.
The insurer appealed an arbitrator's interim expenses decision requiring it to pay $150 to the insured for wasting time at a pre-hearing discussion.
The insurer argued the arbitrator erred by requiring it to negotiate a settlement and by ordering the expenses payable 'forthwith in any event of the cause'.
The Director's Delegate dismissed the appeal, finding the arbitrator did not require settlement but was entitled to enforce meaningful participation in the pre-hearing process.
The Delegate also found the arbitrator had evidence to support her decision and that the issue of the interim expenses order being payable 'in any event of the cause' was moot since the underlying matter had settled.
Insurer ordered to pay costs for refusing to engage in settlement talks at pre-hearing discussion.
The applicant was injured in a motor vehicle accident and applied for statutory accident benefits, which the insurer denied.
At a pre-hearing discussion, the insurer refused to engage in settlement talks unless the applicant also discussed an unmediated claim from a second accident.
The arbitrator found the insurer's conduct inappropriate and ordered the insurer to pay $150 in costs for wasting the applicant's time.
Additionally, the arbitrator ordered the insurer to provide cogent reasons why a preliminary issue hearing regarding the applicant's alleged failure to attend medical examinations should proceed, given documentary evidence suggesting she had attended.