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Application for statutory accident benefits for an RV, home modifications, and business class flights dismissed.
The applicant, who suffered a catastrophic impairment in a 2007 motor vehicle accident, sought funding for a recreational vehicle ($226,200), home modifications including backyard cement work and pool upgrades ($14,443.65), and business class air tickets ($8,239.84) to facilitate travel and family engagement.
The Licence Appeal Tribunal dismissed the application, finding that none of the requested expenses were reasonable and necessary.
The Tribunal relied on medical evidence indicating that the applicant's physical and psychological limitations would prevent her from safely and effectively utilizing the RV, the proposed backyard modifications, or the business class flights to achieve the stated rehabilitation goals.
Income replacement benefits from a prior accident are not included in calculating pre-accident income.
The appellant, a self-employed carpenter, was injured in a motor vehicle accident and received income replacement benefits (IRBs).
Shortly after returning to work, he was injured in a second accident.
The insurer accepted the claim for IRBs but refused to include the IRBs from the first accident in the calculation of his pre-accident income.
The Director's Delegate dismissed the appeal, holding that under the SABS-1996, temporary disability benefits such as IRBs are not considered income from employment and cannot be included in the calculation of pre-accident income, despite the harsh result for the appellant.
WSIB may require an injured worker to reimburse benefits before allowing re-election to sue a tortfeasor.
The worker was injured in a motor vehicle accident during the course of her employment and elected to receive workers' compensation benefits.
She later sought to withdraw her claim to pursue a civil action against the alleged tortfeasor.
The Workplace Safety and Insurance Board required her to agree to reimburse the benefits paid to her as a condition of re-election.
The application judge held that the Board could not require reimbursement because the Insurance Act removed its right of subrogation.
The Court of Appeal allowed the appeal, holding that the arrangement between the Board and the worker was not subrogation, and the Board retained the right to require reimbursement directly from the worker to prevent double recovery.
Prior income replacement benefits cannot be included as employment income to calculate subsequent accident benefits.
The applicant was injured in a motor vehicle accident and applied for income replacement benefits (IRBs).
He disputed the insurer's calculation, arguing that IRBs he received from a previous motor vehicle accident should be included as 'gross income from employment' under the Statutory Accident Benefits Schedule.
The arbitrator held that IRBs from a previous accident cannot be included as income for the purpose of determining the IRB entitlement for the subsequent accident, following established jurisprudence that distinguishes between employment income and payments for loss of income.
Appeal dismissed; appellant insurer held responsible for statutory accident benefits and CPP benefits not deductible.
The appellant insurer appealed an arbitration decision holding it responsible for paying the respondent's statutory accident benefits, valuing the respondent's fringe benefits for income calculation, and refusing to deduct CPP disability benefits.
The Director's Delegate dismissed the appeal, finding that the respondent was not a 'named insured' under the garage policy of his father's company despite being listed in an endorsement.
The Delegate also upheld the arbitrator's factual findings regarding the valuation of the respondent's payment-in-kind and confirmed that CPP benefits were not deductible.
CPP disability benefits are non-indemnity payments and are not deductible from statutory accident benefits.
The applicant was injured in a motor vehicle accident and received statutory accident benefits as well as CPP disability benefits.
The insurer argued that the parties had previously reached a binding settlement that CPP benefits were deductible, and alternatively, that CPP benefits are payments for loss of income and thus deductible under the Schedule.
The arbitrator found that no binding settlement was reached as there was no consideration given for the applicant's prior acknowledgement of the state of the law.
Furthermore, following appellate authority, the arbitrator held that CPP disability benefits are non-indemnity payments triggered by disability, not payments for loss of income, and therefore are not deductible from the applicant's gross weekly income.
Lloyd's held responsible for accident benefits; non-monetary employment benefits included in gross weekly income.
The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.
A priority dispute arose between General Accident and Lloyd's.
The arbitrator determined that Lloyd's was responsible for paying benefits because the applicant was a 'named insured' under the Lloyd's policy, whereas he was merely listed as a driver on an endorsement under the General Accident policy.
The arbitrator also determined the value of non-monetary benefits (lodging, food, and tobacco) provided by the applicant's employer to be included in his gross weekly income calculation, despite the applicant's failure to declare these benefits on his income tax returns.
