Category: Reconsideration

P.B. v. Aviva General Insurance Company(19-009287)

The claimant filed a request for reconsideration following a decision in which the Tribunal concluded that he was not entitled to NEBs. Adjudicator Watt noted that the claimant was trying to re-argue its case, and that a reconsideration is not an opportunity to reargue arguments that previously failed. As such, he dismissed the reconsideration request.

A.G. v. Allstate Canada (18-004980)

The claimant filed a request for reconsideration following a decision in which the Tribunal concluded that the claimant’s death was not caused by the subject accident. The claimant argued that the Tribunal failed to properly analyze the evidence and over-exaggerated his pre-accident medical history. Adjudicator Watt dismissed the reconsideration request, finding that there was no misinterpretation or disregard of medical evidence relating to the claimant’s death.

S.S.R. v. Unifund Assurance Company (18-004772)

The insurer sought reconsideration of the Tribunal’s award of NEBs and medical benefits, and that section 55 did not prevent the claimant from disputing entitlement to the medical benefits. Vice Chair Lester granted the reconsideration in relation to NEBs, but only in ordering that NEB entitlement began six months after the accident as opposed to four weeks, since the claim was under a transitional policy. The reconsideration was dismissed in relation to entitlement to benefits because no error in law was identified by the insurer and the findings of fact were permissible based on the evidence before the Tribunal. In terms of IE non-attendance, Vice Chair Lester noted that section 55 would only apply if the IEs in question were in relation to a disputed benefit. The notices of examination did not indicate which medical benefits were being addressed, so the Tribunal could not determine if section 55 applied.

S.G. v. Wawanesa Mutual Insurance Company (18-001861)

The claimant sought reconsideration of the Tribunal’s denial of IRBs and the cost of an accounting report. Adjudicator Parish concluded that the Tribunal had not made a significant error or law or fact such that it likely would have reached a different conclusion. Most of the arguments made by the claimant were, in essence, an effort to re-argue the case.

O.R.O. v. Aviva Insurance Canada (18-007650)

The claimant sought reconsideration of the Tribunal’s denial of disputed medical benefits. Adjudicator Baker was not persuaded that there was an error in law committed by the Tribunal and that the claimant’s reconsideration was a request to re-litigate the dispute.

V.R. v. Aviva Insurance Company (18-002880)

The claimant sought reconsideration of the Tribunal’s decision not to award various medical benefits. Adjudicator Flude rejected the request. He wrote that the reconsideration request was essentially a request that the Tribunal reverse its findings of fact and prefer the claimant’s assessor over the insurer’s assessor. The reconsideration request was dismissed.

S.M. v. Aviva General Insurance Company (18-003786)

The claimant sought reconsideration of the Tribunal’s denial of IRBs. Adjudicator Watt dismissed the reconsideration request. He held that none of the grounds of Rule 18.2 were satisfied. The Tribunal had considered all the evidence and weighed the evidence as it felt appropriate. The reconsideration was not an opportunity to re-argue the dispute.

O.S. v. Travelers Insurance (18-003385)

The claimant sought reconsideration of the Tribunal’s decision to keep the claimant in the MIG and dismissing the claims for three medical benefits. Adjudicator Watt dismissed the reconsideration request. He held that none of the grounds of Rule 18.2 were satisfied. The Tribunal had considered all the evidence and weighed the evidence as it felt appropriate. He noted that a diagnosis of chronic pain did not automatically remove an insured from the MIG.

S.R. v. Aviva Insurance Canada (17-008249)

The claimant sought reconsideration of the Tribunal’s decision that he was barred from pursuing his claim due to failure to attend an orthopaedic assessment. Vice Chair Marzinotto granted the reconsideration due to the failure of the insurer to note the IE assessor’s regulated health profession. It was the insurer’s obligation to provide that information, not the claimant’s job to investigate it. Vice Chair Marzinotto also ordered that because the insurer ceased payment of IRBs based on the IE non-attendance, which was improper, that IRBs were to be paid for the ten month suspension.

B.C. v. Aviva Insurance Company (17-007448)

The claimant sought reconsideration of the Tribunal’s refusal to remove him from the MIG. Adjudicator Norris rejected the reconsideration request. He wrote that the Tribunal had not failed to consider the OCF-3s, and had not overlooked diagnoses alleged by the claimant. Rather, the Tribunal had weighed the evidence differently and did not accept the claimants submissions. There was no error in law. He also dismissed the arguments relating to section 38(8) because it was a new argument and not before the Tribunal at the hearing.