Category: Divisional Court

Sorrentino v. Certas Home and Auto Insurance Company (2025 ONSC 1578)

The claimant appealed the Tribunal’s denial of home modifications. The primary basis for the denial was that the modifications proposed were to the claimant’s daughter’s home, rather than the condo that the claimant lived in at the time of the accident. The Court allowed the appeal and ordered the insurer to fund the home modifications. The Court ruled that an “existing home” does not need to be the home a person lived in at the time of the accident, and can include a property that a person has moved to after the accident and is living in on a full time basis.

Mohammed v. TTC Insurance Company Limited (2026 ONSC 1477)

The claimant was injured on a TTC bus when the bus stopped suddenly. The LAT concluded she was not entitled to accident benefits due to section 268(1.1) of the Insurance Act, which bars a claim on public transit if there is no collision. The claimant appealed the decision. The Court dismissed the appeal, holding that the section required the bus collide with another object for entitlement to be triggered in the circumstances. The fact that the claimant herself collided with the interior of the bus did not satisfy the requirements of section 268(1.1).

Intact Insurance Company v. Carpenter (2026 ONSC 1443)

The claimant was injured when he was struck by a Caterpillar Small Wheel Loader being driven on a municipal road to clear snow. The insurer denied entitlement to accident benefits on the basis that the equipment was not an automobile. The Tribunal concluded that the equipment was an automobile, but came to the conclusion on grounds not advanced by either party. The insurer appealed the decision. The Court granted the appeal and remitted the matter to the Tribunal for a new hearing. The Court concluded that the insurer was not granted procedural fairness when the Tribunal disregarded the claimant’s concession that the first part of the Adams test was not met (which the insurer therefore did not make arguments about) and relied on that part of the test to conclude that the equipment was an automobile.

Dorcil v. Wawanesa Insurance (2026 ONSC 1446)

The claimant appealed the Tribunal’s decision that she did not suffer a catastrophic impairment. The Tribunal found a 51 percent WPI. The claimant argued that the Tribunal’s refusal to rate her sleep impairment was unreasonable. The Court dismissed the appeal, concluding that the Tribunal did not err by not rating the sleep impairment. The Tribunal did not conclude that sleep disorder was not a rateable condition, but that the claimant and her experts did not give persuasive evidence that the claimant herself suffered a sleep impairment that warranted rating under the AMA Guides.

Certas Home and Auto Insurance Company v. Okenge (2026 ONSC 1189)

The insurer appealed the Tribunal’s decision that the claimant was an insured person due to dependency for care on his sister. The claimant was 19 years old at the time of the accident, which occurred in Nebraska. The claimant moved to Canada from Uganda when he was 14 years old and lived with his sister for a few years, before moving to Oklahoma to high school and then Nebraska for university. He was living in a student residence when the accident occurred. The Tribunal concluded that the claimant was principally dependent for care on his sister because he maintained her address as his mailing address and returned to her home during holidays and summers; the sister acted like a parent to him, the sister Facetimed with the claimant frequently; the claimant’s mother was unable to provide support and was mostly absent; the claimant never lived independently in his own residence or supported himself financially. The Court dismissed the appeal, holding that the Tribunal applied the proper test and legal principles, and applied those principles to the evidence.

Marcelo v. The Personal Insurance Company (2026 ONSC 974)

The claimant appealed the Tribunal’s decision that her injuries fell within the “minor injury” definition. One of the injuries sustained in the accident was an intracranial brain contusion. The Tribunal held that the injury was a “minor injury” because it was a contusion. The Court allowed the appeal, holding that an intracranial brain contusion was not a “minor injury” and that the claimant was entitled to medical benefits above the $3,500 limit.

Economical Insurance Co. v. Abou-Gabal (2026 ONSC 42)

The insurer appealed the Tribunal’s decision that the claimant suffered a catastrophic impairment. The claimant was injured in a minor accident. She had pre-existing severe autism. The insurer’s primary argument was the that claimant’s functioning did not change after the accident, and that the claimant already suffered a catastrophic-like level of impairment. The adjudicator hearing the matter was a member of an autism interest group, had a sibling with autism, and wrote articles in support of greater funding for persons with autism. The Court held that there was a reasonable apprehension of bias, and sent the matter back to the Tribunal for a new hearing. The Court explained that while a decision maker does not have leave their personal life behind when they become an adjudicator, they are expected to publicly withdraw from advocacy on issues that may come before them, or alternatively, to identify the potential appearance of bias and recuse from the matter.

Nuroh v. TD General Insurance Co. (2025 ONSC 6997)

The claimant appealed the Tribunal’s decision that she did not suffer a catastrophic impairment, arguing that the Tribunal’s failure to summons the insurer’s IE witness resulted in procedural unfairness. The Court agreed and ordered a new hearing. The Court wrote that the Tribunal, despite having its own Rules, must afford parties procedural fairness. The insurer’s IE witness was central to the catastrophic impairment issue, and the refusal to provide a summons of the witness prevented the claimant from advancing her own case. The Court noted that the insurer did attempt to procure the IE witness’ attendance, but it was the Tribunal that failed to provide procedural fairness because it was the only entity with the power to summons the witness.

Hasan v. Allstate Insurance Company (2025 ONSC 1562)

The claimant appealed the Tribunal’s decision that he was bound by a settlement. He argued that the allocation of $0 to certain benefits showed that those benefits were not settled. The Court rejected the claimant’s arguments and dismissed the appeal. The SDN and Release were clearly a settlement of all claims arising out of the accident. Additionally, the claimant had not repaid the settlement funds to the insurer, which barred him from advancing the claim to resile from the settlement.

Sorrentino v. Certas Home and Auto Insurance Company (2025 ONSC 5518)

The claimant appealed the Tribunal’s denial of a $365,257 home modification to the claimant’s daughter’s home. The Court granted the appeal with immediate effect, ordering the insurer to pay the home modifications, with written reasons to follow. The Court explained that the claimant’s age made it unfair for the matter to be remitted to the Tribunal for a new hearing, and that the claimant required the modifications to ensure she did not suffer another injurious fall.

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