Category: Income Replacement Benefits

Traders General Insurance Company v. Rumball (2025 ONSC 656)

Post author By tgp-admin
Post date September 23, 2025
No Comments on Traders General Insurance Company v. Rumball (2025 ONSC 656)

The claimant appealed the Divisional Court’s decision that upheld the denial of post-104 IRBs. She argued that the Court and Tribunal failed to apply the proper test. In particular, the claimant argued that the Court failed to consider whether suitable employment existed in a real-world setting, and in putting the onus on her to prove her inability to work. The Court dismissed the appeal, holding that the post-104 IRB test required an evidence-based, contextual analysis. Factors such as competitive, real-world setting, status, and remuneration of alternative employment were relevant, but were not stand-alone requirements. The Court also held that the onus was on the insured to prove her entitlement to post-104 week IRBs.

Gutierrez v. Security National Insurance Company (2025 ONSC 5174)

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Post date September 17, 2025
No Comments on Gutierrez v. Security National Insurance Company (2025 ONSC 5174)

The claimant sought judicial review of the LAT’s decision that he was not entitled to IRBs, and the LAT’s refusal to add the claim for pain and suffering. The Divisional Court dismissed the judicial review, holding that the Tribunal considered the evidence before it when adjudicating the IRB claim, and that the Tribunal reasonably declined to add a claim for pain and suffering.

Park v. GEICO Insurance Company (2025 ONSC 4282)

Post author By tgp-admin
Post date July 23, 2025
No Comments on Park v. GEICO Insurance Company (2025 ONSC 4282)

The claimant appealed the Tribunal’s decision that he was not entitled to IRBs. The Court dismissed the appeal, holding that the claimant received a fair hearing, and that the alleged uneasonableness in factual and evidentiary findings was not proven. The record showed no unreasonableness in the Tribunal’s findings or inferences drawn from the findings.

Derenzis v. Gore Mutual Insurance Co. (2025 ONSC 2732)

Post author By tgp-admin
Post date June 5, 2025
No Comments on Derenzis v. Gore Mutual Insurance Co. (2025 ONSC 2732)

The claimant appealed the Tribunal’s decision that she was not entitled to IRBs due to IE non-attendance. The Court dismissed the appeal, concluding that the Tribunal did not make an error. The Court found that the IE notices were adequate, and that the Tribunal was entitled to consider the cumulative effect of the prior IE notices in determining compliance. The Court also rejected the arguments made by the claimant regarding the Tribunal lacking impartiality.

Jendrika v. Intact Insurance Company (2025 ONSC 652)

Post author By tgp-admin
Post date January 30, 2025
No Comments on Jendrika v. Intact Insurance Company (2025 ONSC 652)

The claimant appealed the Tribunal’s decision that she was not entitled to IRBs or disputed medical benefits. The Court dismissed the appeal, holding that there was no procedural unfairness in conducting a written hearing, and that the claimant’s appeal was largely based on disagreement on the weight to be given to the evidence and expert opinions. Neither party made submissions regarding the MIG, so the adjudicator was entitled to conclude that it was not an issue in dispute. Finally, the Tribunal applied the correct test for pre-104 week and post-104 week IRBs.

Kumar v. Aviva General Insurance Company (2024 ONSC 5882)

Post author By tgp-admin
Post date October 28, 2024
No Comments on Kumar v. Aviva General Insurance Company (2024 ONSC 5882)

The claimant appealed the Tribunal’s decision that he was not entitled to post-104 week IRBs, and the Tribunal’s decision refusing to extend the time for reconsideration. The Court dismissed the appeal and the judicial review, holding that the Tribunal did not make any reviewable errors. The adjudicator was entitled to control the process with respect to the examinations and cross-examinations of witnesses, and the adjudicator applied the property “complete inability” test in the context of the evidence presented at the hearing.

Achaia-Shiwram v. Intact Insurance Company (2024 ONSC 5479)

Post author By tgp-admin
Post date October 8, 2024
No Comments on Achaia-Shiwram v. Intact Insurance Company (2024 ONSC 5479)

The claimant appealed the Tribunal’s decision that she did not suffer a catastrophic impairment and that she was not entitled to IRBs. She argued that the Tribunal erred in its causation analysis, in considering pre-existing conditions, and in attributing impairments to a subsequent event. The Court dismissed the appeal. The Court held that the Tribunal did not make any legal errors in its decision. The Tribunal correctly used the “but for” test in determining causation of the psychological injuries, and was correct in considering the claimant’s pre-accident and post-accident functioning in order to determine the cause of the psychological injuries. Finally, the Court held that the Tribunal’s consideration of a subsequent injury as an intervening event was not an error of law.

Said v. Northbridge General Insurance Company (2024 ONSC 5248)

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Post date September 25, 2024
No Comments on Said v. Northbridge General Insurance Company (2024 ONSC 5248)

The claimant appealed the Tribunal’s dismissal of her claims based on res judicata. The Court dismissed the appeal, holding that the claimant’s remedy if she disagreed with the first decision was to seek reconsideration or appeal of that decision. The Tribunal’s second decision based on res judicata was correct in law, and did not result in procedural unfairness.

Landa v. The Dominion of Canada General Insurance Company (498/21; 152/22; 396/23; 397/23)

Post author By tgp-admin
Post date June 21, 2024
No Comments on Landa v. The Dominion of Canada General Insurance Company (498/21; 152/22; 396/23; 397/23)

The claimant appealed and sought judicial review in relation to five LAT decisions. The accident that gave rise to the claims occurred in 2007. The issues in dispute in the LAT hearings included the limitation period and entitlement to IRBs and medical benefits. The Court examined whether the LAT decisions disclosed an error of law, were unreasonable, or were rendered in a manner that breached procedural fairness. The appeals and judicial review applications were dismissed.

Adam v. Aviva General Insurance Company (2024 ONSC 3577)

Post author By tgp-admin
Post date May 21, 2024
No Comments on Adam v. Aviva General Insurance Company (2024 ONSC 3577)

The claimant appealed the Tribunal’s decision that he was not entitled to post-104 week IRBs. The Court rejected the appeal, holding that the Tribunal correctly concluded that the insurer complied with section 37 regarding the denial of IRBs, and the denial did not lack medical reasons or specificity for the denial. The Court also dismissed the arguments that the Tribunal did not properly weigh the evidence.

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