2 total
Appeal from LAT dismissed; adjudicator reasonably found injuries fell within the Minor Injury Guideline.
The appellant appealed a Licence Appeal Tribunal decision that found his injuries from a motor vehicle accident fell within the Minor Injury Guideline (MIG) and denied two treatment plans for assessments.
The Divisional Court held that the adjudicator made no error of law and reasonably concluded that the appellant failed to meet his burden of proving entitlement to benefits beyond the MIG cap.
The appeal was dismissed.
Catastrophic impairment application must specify one accident, though cumulative injuries may be considered.
The insurer applied for a determination of whether s. 45 of the Statutory Accident Benefits Schedule requires an insured to identify a single accident when applying for a catastrophic impairment designation.
The insured had been involved in three motor vehicle accidents and submitted a single OCF‑19 application claiming catastrophic impairment based on the cumulative effects of all three accidents.
The court interpreted the legislation and regulatory scheme and concluded that the catastrophic impairment determination must be anchored to a single identified accident.
However, the insured may still rely on the cumulative impact of prior accidents where the specified accident represents the tipping point leading to catastrophic impairment.
The court therefore granted the application in part and declared that the application must specify one accident.
