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Vivekanantham v. Certas Direct Insurance Company (2024 ONSC 6198)

  • November 12, 2024

The claimant appealed and sought judicial review of the Tribunal’s decision that she did not sustain a catastrophic impairment and that she was not entitled to a special award. At the Tribunal hearing, the insurer’s psychiatric assessor refused to attend to give evidence despite a summons, but the adjudicator still allowed the IE report to be considered. Also during the hearing, the insurer conceded the claimant’s entitlement to IRBs, removal from the MIG, and entitlement to medical benefits, and paid amounts owing plus interest. However, the adjudicator concluded that she did not have jurisdiction to grant a special award once the benefits were approved. The Court granted the appeal, holding that the Tribunal erred when it failed to consider whether to make a special award on IRBs and the approved medical benefits, and in breaching procedural fairness when it admitted the psychiatry IE despite the refusal of the assessor to attend the hearing. The Court wrote that the Tribunal should have excluded the IE report once it was clear the assessor would not attend the hearing. The Court remitted the matter to the Tribunal for a new hearing.

Full decision here

TGP Analysis

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  • FILED UNDER Catastrophic Impairment, Special Award, Divisional Court
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