The insurer appealed the Tribunal’s decision that the claimant’s slip and fall on ice met the definition of accident. The claimant’s application included other disputes relating to accident benefits claims that were not yet decided. The Court held that the insurer’s appeal was premature as the accident definition decision was interlocutory. The Court wrote that it would have jurisdiction to hear the insurer’s appeal of that issue once the Tribunal had determined all issues in dispute.
The claimant appealed the Tribunal’s denial of IRBs and a special award, arguing that the decision lacked procedural fairness, reasonableness, and did not consider key evidence. The Court dismissed the appeal, holding that the Tribunal provided the claimant with an opportunity to present his case, and holding that the Tribunal was not required to cite every document submitted by the claimant in its reasons.
The claimant appealed the LAT’s dismissal of his catastrophic impairment dispute, arguing that the Tribunal’s supplemental reasons contained in the reconsideration decision violated the principles of fairness. The Court dismissed the appeal, holding that the SPPA gave the Tribunal the power to make rules to reconsider its own decision, and that the reconsideration process gave the Tribunal the ability to dismiss, confirm, vary, or cancel any part of its original decision or order. The Tribunal’s procedure in the subject matter followed the reconsideration process contemplated by the SPPA and the Tribunal’s own rules. The Tribunal acted entirely within its own jurisdiction on the reconsideration.
The claimant sought a stay from Divisional Court of the LAT’s decision that the dispute would proceed in writing rather than orally. The Court rejected the stay, holding that there was not a serious issue, there was no irreparable harm if the stay was not granted, and the balance of convenience did not favour the claimant given the prematurity of the decision. The Court wrote that if, at the end of the Tribunal’s process, the claimant wished to dispute the fairness of the hearing, he could do so at that time.
This is a reconsideration decision. The claimant had a written hearing submission deadline of October 19, 2022, but did not file submissions until November 10, which was eight days after the respondent filed a Notice of Motion for an order dismissing the application as abandoned. The claimant requested an adjournment. The motion adjudicator denied the request for adjournment and dismissed the application. The request for reconsideration was denied.
The claimant appealed the Tribunal’s decision denying an adjournment of a scheduled hearing. The Court dismissed the appeal, holding that the denial of the adjournment was an interlocutory step from which no appeal was permitted. The Court also declined to grant a stay of the proceedings.
The claimant appealed and sought judicial review of the Tribunal’s decision to dismiss her application due to non-attendance at an IE. The Court dismissed the appeal and judicial review, holding that the Tribunal properly considered the SABS and the materials before it, and the result was a reasonable outcome available to the Tribunal under the SABS. The claimant failed to prove that she was not afforded procedural fairness in the hearing.
The claimant sought a determination that she sustained a catastrophic impairment as a result of the accident. Vice Chair Moore held that the claimant did not suffer a catastrophic impairment under Criterion 7 or Criterion 8. Vice Chair Moore found the insurer’s WPI ratings more persuasive. In particular, the Vice Chair preferred the position of the insurer’s assessors that there needed to be a specific accident-related diagnosis to justify an impairment rating, rather than simply reports of symptoms. Vice Chair Moore was critical of the claimant’s assessors, who appeared to apply WPI ratings in excess of diagnosed accident-related injuries and which were not in accordance with the AMA Guides. Vice Chair Moore found a total of 6 percent WPI for physical impairment, which was too low to combine with psychological impairment to exceed 55 percent WPI. In terms of Criterion 8, Vice Chair Moore found that at least two domains (activities of daily living and concentration, persistence, and pace) did not meet a Class 4 Marked Impairment, and as such, the claimant could not qualify for a catastrophic impairment under Criterion 8. As a procedural preliminary issue, Vice Chair Moore excluded the insurer’s supplementary document brief containing surveillance because it was served on the first day of the hearing. Although the surveillance had been provided during settlement discussions, the Tribunal found that failure to include the surveillance in the original document brief meant that the claimant was not expecting to comment and rebut the findings therein.
The claimant applied to the LAT seeking entitlement to NEBs and interest. During the written hearing, the claimant sought to add a claim for a special award. The Co-operators sought to strike 2 pages of the claimant’s submissions as they were over the 10 page limit ordered at the Case Conference. Furthermore, they sought to have the claim for a special award dismissed. The insurer argued that the claimant submitted pleadings that were 12 pages in length, which was 2 pages over the limit ordered. They relied on A.Y. v. Aviva and F.H. v. Certas Direct Insurance Company, which established that pages submitted beyond the ordered limit in a written hearing were unable to be considered. The insurer further argued that, as per Selby v. Security National, the issue must be added either on consent, or via a motion, neither if which occurred. Vice-Chair Ciriello ruled that the claimant’s submissions beyond the 10 pages ordered were inadmissible, and noted that the claimant had the option to “seek permission” from The Tribunal for additional pages, which they failed to do. With regards to the special award, Vice-Chair Cirello preferred the claimant’s case law (16-004312 v. Aviva Insurance Canada) and upheld that a claim for a special award may be added at any point during the dispute, even during a hearing, as it promoted efficiency. The claimant was not found entitled to NEBs based on the medical evidence and the claim was dismissed.
The claimant appealed the Tribunal’s decision dismissing her claim for IRBs. The Court dismissed the appeal holding that there was no extricable question of law. The Court also rejected the arguments that the Tribunal process lacked procedural fairness or that the Tribunal did not apply the correct test for causation.
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416.507.1850
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Toronto, Ontario M5H 3S5
416.507.1850