Category: Divisional Court

Sahadeo v. Pafco Insurance Company (2023 ONSC 2542)

The claimant appealed the LAT’s dismissal of his catastrophic impairment dispute, arguing that the Tribunal’s supplemental reasons contained in the reconsideration decision violated the principles of fairness. The Court dismissed the appeal, holding that the SPPA gave the Tribunal the power to make rules to reconsider its own decision, and that the reconsideration process gave the Tribunal the ability to dismiss, confirm, vary, or cancel any part of its original decision or order. The Tribunal’s procedure in the subject matter followed the reconsideration process contemplated by the SPPA and the Tribunal’s own rules. The Tribunal acted entirely within its own jurisdiction on the reconsideration.

Nguyen v. Economical Mutual Insurance Company (2023 ONSC 2541)

The claimant appealed the LAT’s decision that the limitation period barred the application. The Court allowed the appeal and remitted the matter to the Tribunal for a new hearing. The Court found the Tribunal erred in concluding that the denial letter was received on the day it was authored, as no evidence was before the Tribunal to prove the date of receipt. The Court also held the Tribunal erred in putting the onus on the claimant to refute the date the insurer alleged the denial letter was received by the claimant in the mail.

Di Giulio v. Aviva General Insurance Company (2023 ONSC 2426)

The claimant sought a stay from Divisional Court of the LAT’s decision that the dispute would proceed in writing rather than orally. The Court rejected the stay, holding that there was not a serious issue, there was no irreparable harm if the stay was not granted, and the balance of convenience did not favour the claimant given the prematurity of the decision. The Court wrote that if, at the end of the Tribunal’s process, the claimant wished to dispute the fairness of the hearing, he could do so at that time.

TD General Insurance Company v. Duff-Foley (Estate) (2023 ONSC 2400)

The insurer appealed the Tribunal’s decision that the settlement between the insurer was valid and enforceable. The claimant died 10 days after settling her tort and AB claims for $957,000, with 60 percent to be structured. The 60 percent was returned to the insurer based on the reversion; however, the claimant’s estate took the position it was entitled to keep the 40 percent. The insurer disagreed, and argued that there was no valid settlement because the claimant died prior to agreement on the structure percentage. The Court dismissed the appeal, holding that the Tribunal applied the correct legal test. Further, the Court wrote that the claimant’s lawyer had authority to negotiate the settlement, and the executor of the estate could execute the agreement by signing the necessary documents.

Tamayo v. Licence Appeal Tribunal (2023 ONSC 1692)

The claimant appealed the Tribunal’s decision denying an adjournment of a scheduled hearing. The Court dismissed the appeal, holding that the denial of the adjournment was an interlocutory step from which no appeal was permitted. The Court also declined to grant a stay of the proceedings.

Lengyel v. The Licence Appeal Tribunal (2023 ONSC 1623)

The claimant appealed and sought judicial review of the Tribunal’s decision to dismiss her application due to non-attendance at an IE. The Court dismissed the appeal and judicial review, holding that the Tribunal properly considered the SABS and the materials before it, and the result was a reasonable outcome available to the Tribunal under the SABS. The claimant failed to prove that she was not afforded procedural fairness in the hearing.

Hutchinson v. Aviva General Insurance Company (2023 ONSC 1472)

The claimant appealed the Tribunal’s decision that she was not entitled to various medical benefits. The claimant argued that the Tribunal’s refusal to convert the videoconference hearing to a written hearing was a breach of procedural fairness and natural justice. The claimant’s counsel had argued that the claimant was unable to participate in the hearing due to psychological injuries, but provided no evidence in support of the motion. The Tribunal rejected the motion and the matter proceeded by videoconference, and the claimant called no evidence. The Court rejected the appeal, holding that the Tribunal’s processes were fair and the decision to proceed with the videoconference was not a breach of procedural fairness or natural justice. The claimant was given the opportunity to make submissions on the motion and the Tribunal provided written reasons for its decision. The Court also rejected the argument that the adjudicator was biased.

Amadiegwu v. Aviva General Insurance Company (2023 ONSC 1256)

The claimant appealed the Tribunal’s decision dismissing her claim for IRBs. The Court dismissed the appeal holding that there was no extricable question of law. The Court also rejected the arguments that the Tribunal process lacked procedural fairness or that the Tribunal did not apply the correct test for causation.

Waterloo Insurance v. Switzer (2023 ONSC 604)

The insurer appealed the Tribunal’s decision regarding the calculation of a self-employed person’s IRB where the person was self-employed for less than one year. The Tribunal allowed the claimant to use income earned from his previous employer, despite not being employed at the time of the accident and not being employed in the six months prior to the accident. The Court overturned the Tribunal’s decision, holding that the claimant was not permitted to use income earned through employment in calculating IRBs because he did not qualify for IRBs as an employed person. As a self-employed person at the time of the accident, the calculation of IRBs was limited to the calculation based on the last completed taxation year, as required by section 4(3). Due to the lack of evidence regarding the property calculation, the Court ordered a new hearing before the Tribunal, applying the proper section of the SABS.

Madore v. Intact Insurance Company (2023 ONSC 11)

The claimant appealed the Tribunal’s decision that he was not involved in an “accident” as defined in the SABS. The claimant had been inspecting and cleaning the roof of his camper trailer, which was hitched to his pickup truck. In the course of cleaning the trailer, the claimant fell to the ground, suffering serious injuries to his head. The Tribunal had found that the “causation” test was not met because there was no direct evidence that the trailer caused the claimant’s fall, and that there was an intervening act, namely the loss of footing, which was not part of the ordinary course of things. The Court reversed the Tribunal’s decision, holding that the Tribunal erred in requiring the claimant to show that the incident was caused by tripping on the trailer or that the injuries were directly caused by the trailer to establish direct causation of the injuries. The fact that the claimant was injured in the course of cleaning and inspecting the roof of the trailer was sufficient to prove that the use and operation of an automobile caused the claimant’s impairments; there was no need to prove a direct physical connection between the cause of the injury and an automobile.

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