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Application for income replacement and medical benefits dismissed as applicant returned to work and lacked medical evidence.
The applicant sought statutory accident benefits, including income replacement benefits (IRBs) and medical benefits for physiotherapy, following a motor vehicle accident.
The Tribunal found that while the insurer failed to comply with the procedural timelines under section 36(4) of the Schedule, creating a period of statutory entitlement to IRBs, the quantum payable was nil because the applicant had returned to work and earned income that offset the benefit.
For the subsequent period, the applicant failed to prove a substantial inability to perform the essential tasks of her employment.
The claims for medical benefits were also dismissed as the applicant did not provide medical evidence to prove the treatments were reasonable and necessary, whereas the insurer's examination reports indicated only minor injuries.
Slipping on ice while walking to a rideshare vehicle is not an 'accident' under SABS.
The respondent slipped and fell on an icy driveway while walking toward a waiting rideshare vehicle.
The License Appeal Tribunal found the incident was an 'accident' under the Statutory Accident Benefits Schedule, entitling her to benefits.
The insurer appealed.
The Divisional Court allowed the appeal, finding the Tribunal erred in law by conflating the 'but for' test with the direct causation test.
The court held that while the vehicle's location led to the respondent being on the icy driveway, the use or operation of the vehicle was not the direct cause of her injuries.
Slip and fall on icy driveway while approaching rideshare vehicle constitutes an accident under the Schedule.
The applicant was injured when she slipped and fell on an icy driveway while walking towards a rideshare vehicle that had arrived to take her to a medical appointment.
The respondent denied her claim for statutory accident benefits on the basis that the incident was not an 'accident' under the Schedule.
The Tribunal found that the incident met both the purpose and causation tests.
The use and operation of the vehicle began when the driver accepted the ride request, and the fact that the driver could not pull up to the entrance, requiring the applicant to walk down the icy driveway, was a direct cause of the injuries.
The Tribunal concluded the incident was an accident and the application for benefits could proceed.
Applicant not precluded from IRB claim where insurer's notice of examination was deficient and unclear.
The applicant sought income replacement benefits following a motor vehicle accident.
The respondent denied the benefits and requested a preliminary issue hearing to determine whether the applicant was precluded from proceeding with his claim under s. 55 of the Schedule for failing to attend an insurer's examination.
The Tribunal found that the respondent failed to provide sufficient notice of the examination, as the medical and other reasons provided were contradictory and confusing.
The Tribunal also determined that the applicant's Disability Certificate (OCF-3) was submitted in or around November 18, 2016.
The applicant was not precluded from proceeding to a hearing on the merits.
Insurer ordered to pay IRB for a limited period due to procedural non-compliance.
The applicant sought an income replacement benefit (IRB) following a motor vehicle accident.
The Licence Appeal Tribunal found that the applicant failed to prove substantive entitlement to an IRB under s. 5(1) of the Statutory Accident Benefits Schedule.
However, because the insurer failed to respond to the application within ten business days, the applicant was procedurally entitled to an IRB of $400 weekly for the period between October 21, 2015, and May 1, 2017, pursuant to s. 36(6) of the Schedule.
Claims for a special award and costs were dismissed.
Unregistered commercial lease found valid through part performance and binding on wilfully blind purchaser.
The applicant tenant sought a declaration that its commercial lease was valid and binding on the new owner of the building.
The applicant had signed a new five-year lease with the previous landlord, but the landlord claimed it was never received.
Both parties, however, acted as if the lease were in effect, with the applicant paying increased rent.
The new owner purchased the building and claimed the applicant was a month-to-month tenant, seeking to significantly increase the rent.
The court found that the lease was valid and enforceable through the doctrine of part performance.
Furthermore, the court held that the unregistered lease was binding on the new owner because the new owner was wilfully blind to the existence of the lease during the purchase process.
Insurance policy exclusions barred coverage for damage caused by insured’s own work.
The appellant contractor scratched approximately 180 windows while performing cleaning services at a newly constructed commercial building and reimbursed the building owner about $134,000 for the damage.
It sought indemnification under its commercial general liability policy, but the insurer denied coverage relying on “your work” exclusions.
The motion judge granted summary judgment dismissing the action.
The Court of Appeal held that the occurrence causing the property damage was the scratching of the windows during the cleaning operation and that the damage arose out of the insured’s work.
Because the property damage fell squarely within the policy’s exclusions, coverage was properly denied and the appeal was dismissed.
Appeal quashed for want of jurisdiction as the order granting leave to amend pleadings was interlocutory.
The defendants appealed an order granting the plaintiff leave to amend her statement of claim in an occupier's liability action.
The defendants argued the amendment introduced a new cause of action outside the limitation period, making the order final.
The Court of Appeal disagreed, finding the amendment merely alleged an alternative factual scenario for the fall and did not add a new cause of action.
As the order was interlocutory, the appeal was quashed for want of jurisdiction, with costs awarded to the plaintiff.