Category: LAT Rules

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.

The claimant appealed the Tribunal’s decision that he did not suffer a catastrophic impairment as a result of the accident. The Court dismissed the appeal, holding that the claimant did not raise any legal errors on the part of the Tribunal. The Tribunal’s factual findings were supported by the evidence presented by the parties, and the Tribunal was entitled to make assessments of the witnesses credibility. Additionally, the Tribunal’s reliance on medical records by a doctor not present at the hearing was permitted, as hearsay evidence is permissible in hearings before the Tribunal.