3 total
Slipping on ice while clearing snow from a vehicle constitutes an 'accident' for statutory accident benefits.
The applicant sought statutory accident benefits after slipping and falling on ice while clearing snow from her vehicle.
The respondent insurer denied benefits, arguing the incident did not meet the definition of an 'accident' under the Schedule and questioning the applicant's credibility regarding the sequence of events.
The Tribunal accepted the applicant's version of events and applied the two-part purpose and causation test.
The Tribunal found that clearing snow is an ordinary use of a vehicle and that the ice was a normal risk, not an intervening cause.
The Tribunal concluded the incident was an 'accident' and ordered the matter to proceed to a hearing on the substantive issues.
The court granted leave to amend the statement of defence, finding no admissions were withdrawn.
The decision concerns a motion by the Defendants to amend their Statement of Defence in an estate dispute regarding whether a $160,000 transfer from the deceased to his cousin was a loan or a gift.
The court finds that the proposed amendments do not constitute a withdrawal of admissions, and grants leave to amend under Rule 26.01, as no non-compensable prejudice to the Plaintiff is established.
The ruling clarifies the distinction between factual and legal admissions in pleadings and the applicable test for amendments.
Claim for file review summary dismissed as it is not an independently billable task under the Schedule.
The applicant sought payment of $2,260.00 for a file review summary proposed in a treatment plan following a motor vehicle accident.
The respondent denied the expense on the basis that it was duplicative, as a file review is included in the cost of each approved assessment.
The Tribunal agreed, finding that a file review is a necessary component of an assessment and not an independently billable task under s. 25(5) of the Schedule.
The Tribunal also found the respondent's denial letter complied with s. 38(8) by providing a clear non-medical reason for the denial.
The application was dismissed.
