The claimant twice adjourned a hearing, and then failed to attend the rescheduled hearing. The insurer sought a dismissal of the application. Adjudicator Parish granted the dismissal on the basis the claimant had abandoned the claim.
Category: LAT Rules
The claimant was injured in an icy parking lot. She was a few feet from her vehicle when she slipped and fell. She applied for accident benefits. The insurer denied coverage on the basis that the incident was not an “accident” under the SABS. Adjudicator Ferguson concluded that the facts of loss were not an “accident.” He reasoned that neither the vehicle nor any action associated with use of the vehicle was a factor in the claimant’s injuries. The chain of causation was broken. Adjudicator Ferguson also held that the insurer was not estopped from arguing that an accident had occurred, despite initially paying the claimant benefits for three years.
Vice-Chair Helt dismissed the insurer’s request for reconsideration. The insurer alleged that the LAT violated the rules of natural justice and procedural fairness and made significant errors of law. The parties had agreed upon a document exchange deadline. The claimant brought a motion following the deadline, requesting an opportunity to file an affidavit. The LAT allowed the claimant to file the affidavit, but limited the scope of the affidavit to an orthopaedic assessment. The insurer was not permitted to cross-examine the claimant on her affidavit. Vice-Chair Helt held that any prejudice resulting to the insurer was remedied with the opportunity to respond to the affidavit. The Vice-Chair also held that there are instances where additional evidence may be allowed to be filed after deadlines if it is in the interest of ensuring there is a complete record before the adjudicator. In this matter, the LAT allowed the additional affidavit evidence, but limited it in scope and provided the insurer an opportunity to respond.
The claimant sought reconsideration of the Tribunal’s decision that the IRB claim was not barred by the limitation period. The request was made more than 12 months after the Tribunal’s decision. Vice Chair Batty dismissed the request, holding that it was made outside of the required time period, and that the LAT Rules did not favour extending the 21 day deadline.
The Tribunal granted the claimant’s request to have two applications heard together. The insurer sought reconsideration. Vice Chair Batty dismissed the request on the basis that the Tribunal’s order was not an order that finally disposed of an appeal. Because the proceeding was ongoing, the insurer could not yet seek reconsideration.
The Tribunal ordered the insurer to produce the adjuster’s log notes, the complete accident benefits file, and raw data from IE assessors. The insurer sought reconsideration. Vice Chair Batty dismissed the request, reasoning that the disputed orders were not decisions that finally disposed of the appeal.
The claimant brought a motion to exclude the transcripts from the criminal proceeding. Adjudicator Maedel dismissed the motion, holding that admissibility of evidence was to be left to the hearing adjudicator subject to relevance, privilege, or inadmissibility.
The claimant sought a request for reconsideration following a denied request to adjourn a hearing on consent. The Tribunal initially denied the adjournment request because there was no evidentiary basis to support the request. Associate Chair Batty granted the reconsideration request because the claimant submitted information that demonstrated compelling personal reasons why counsel could not attend on short notice. The hearing was too close to assign the file to another counsel and the respondent had consented to additional dates.
The claimant sought reconsideration of the adjudicator’s preliminary decision that IRBs and ACBs were statute barred and would not be addressed in the hearing. It was clear from review of the adjudicator’s decision that ACBs were not meant to be statute-barred, and the typographical error in the decision was amended pursuant to Rule 19. The reconsideration in relation to IRBs was dismissed in accordance with Rule 18 which prohibited reconsideration unless the decision finally disposed of the application.
The claimant sought production of log notes from the date of the first FSCO arbitration application up to the date of the LAT application. The insurer argued that these notes were protected by privilege. Adjudicator Fricot concluded that the log notes between the date of the FSCO arbitration application up to the date of the LAT application were producible if the notes pertained to one of the accident benefits in dispute, and were not protected by privilege. The insurer was required to consider each relevant log note entry and explain whether it was subject to litigation privilege or solicitor-client privilege. The insurer was also permitted to redact reserve information.