Category: LAT Rules

The claimant appealed the Tribunal’s decision that she did not suffer a catastrophic impairment due to three Class 4 marked impairments. The claimant argued that the Tribunal acted unfairly in limiting the time for examination and cross-examination of witnesses, and by allowing the insurer’s expert to comment on the claimant’s expert’s report but not vice versa. The Court dismissed the appeal, finding that the Tribunal acted fairly. The adjudicator was entitled to control the process, and the time limits on examination and cross-examination were applied fairly and equally to all witnesses, and the parties were able to call all witnesses they wished to testify. The Court did not find unfairness in the adjudicator allowing the insurer’s expert to comment on the claimant’s expert’s report while disallowing the reverse because the insurer’s expert had a copy of the claimant’s expert’s report when generating his own report, whereas the claimant’s expert did not have the insurer’s expert’s report when generating his report. Further, the claimant could have requested an addendum report from her own expert to respond to the insurer’s expert, but chose not to.

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.

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.

The claimant appealed the Tribunal’s decision that he did not suffer a catastrophic impairment. The claimant raised multiple procedural issues and fairness issues. The Court dismissed the appeal, holding that the reasons applied the correct legal tests and provided detailed, comprehensive reasons for the conclusions reached. The causation test used by the Tribunal was correct, and the Tribunal’s conclusion that the alleged injuries and impairments were not caused by the accident was supported by the record. The claimant was given a seven day hearing and was allowed to present her case, call witnesses, cross-examine the insurer’s experts, raise objections, and make submissions. There was no indication that the hearing was conducted in a manner inconsistent with procedural fairness or the claimant’s expectations.