Category: LAT Rules

D.T. v. Wawanesa Mutual Insurance Company (18-005613)

The claimant sought entitlement to IRBs, the MIG, and various medical benefits. The insurer argued that the claimant’s entitlement to IRBs had already been decided and was res judicata. The Tribunal had already adjudicated an application for IRBs (among other things), which was upheld on reconsideration and at the Divisional Court. There was no new evidence to support that the claimant had additional injuries or conditions. The new medicolegal reports the claimant obtained could have been obtained prior to the first hearing.

P.Y. v Aviva General Insurance Company (17-003692)

The claimant sought reconsideration of the Tribunal’s decision based on there being new evidence that the claimant could not have reasonably obtained earlier and based on the insurer’s concession at the close of the proceedings that the MIG did not apply. Adjudicator Grieves granted the claimant’s reconsideration request. Adjudicator Grieves accepted that the new evidence, being a s. 25 psychological report, was not reasonably available to the claimant at the time of the hearing and would have affected the Tribunal’s result with respect to its MIG finding. Adjudicator Grieves also criticized the parties for not advising the Tribunal that the insurer had agreed at the close of proceedings to remove the claimant from the MIG, as this would have affected the Tribunal’s result. Adjudicator Grieves ordered that the matter be sent back to the Tribunal to determine the reasonableness and necessity of the disputed treatments plans as the claimant was now out of the MIG.

C.S. v. Aviva Insurance Company (18-007039)

The claimant sought reconsideration of a motion order denying the request to strike the insurer’s evidence. Associate Chair Batty dismissed the reconsideration because it was not related to a final order.

K.A. v. TD Insurance Company (18-009613)

The insurer sought reconsideration of a motion order denying the request to adjourn the scheduled hearing. Associate Chair Batty dismissed the reconsideration because it was not related to a final order.

G. I-F. v. Economical Insurance Company (19-001420)

The claimant sought reconsideration of a motion order denying the request to vary the hearing timetable. Associate Chair Batty dismissed the reconsideration because it was not related to a final order.

Applicant v. Gore Mutual Insurance Company (18-011978)

The claimant sought an order from the case conference adjudicator that his decision not to strike the insurer’s preliminary issue was biased and requested that the adjudicator recuse himself. Adjudicator Mazerolle refused the request. He explained that his decision was based on the written submissions of both parties and that a reasonable person would not view the process with a reasonable apprehension of bias.

C.B. v. Allstate Insurance Company of Canada (18-009967)

The insurer asked for an extension of time to serve a motion record in relation to the claimant’s motion to exclude certain evidence from an upcoming hearing. Adjudicator Paluch granted the extension and vacated the scheduled hearing dates in order for the motion to be heard. He wrote that the insurer inadvertently failed to serve only one of three parts of the motion record and should not be prejudiced by that mistake.

S.A. v. Guarantee Insurance (18-002962)

The claimant sought reconsideration of the Tribunal’s decision that he was not entitled to NEBs. He argued, among other things, that the Tribunal’s refusal to allow closing arguments violated the rules of natural justice. Vice Chair Jovanovic agreed that the Tribunal breached the rules of natural justice by not allowing closing submissions. The Tribunal could have easily accommodated the request to make submissions, and the claim for NEBs was of considerable importance to the claimant, who was only receiving ODSP as her other source of income.

S.A. v. Guarantee Insurance (18-002962)

The claimant sought reconsideration of the Tribunal’s decision that he was not entitled to NEBs. He argued, among other things, that the Tribunal’s refusal to allow closing arguments violated the rules of natural justice. Vice Chair Jovanovic agreed that the Tribunal breached the rules of natural justice by not allowing closing submissions. The Tribunal could have easily accommodated the request to make submissions, and the claim for NEBs was of considerable importance to the claimant, who was only receiving ODSP as her other source of income.

H.S. v. Aviva Insurance Canada (17-007384)

The claimant sought removal from the MIG and entitlement to four treatment plans for physical therapy. As a preliminary matter, the insurer sought to admit as evidence two addendum report authored after the production deadline. Adjudicator Harper refused to admit the addendum reports, reasoning that they could have been obtained much earlier, since the records reviewed were in the insurer’s possession for some time. Regarding the claimed benefits, Adjudicator Harper concluded that the claimant suffered a concussion, which fell outside of the MIG. She also concluded that the disputed physical treatment was reasonable and necessary because the claimant had long-lasting injuries and she had not achieved maximal recovery.

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