Full Decision This case involves a dispute between the plaintiff and her insurer over the payment of Income Replacement Benefits (“IRBs”) beyond the first two years following the collision. The plaintiff was injured in a motor vehicle collision (“MVC”) on November 18, 2018. At the time of the collision, she was working at Mohawk College as a part-time professor teaching recreation therapy 1-6 hours per …
Huber v. Allstate (“Huber”) involved an accident benefits dispute before the Licence Appeal Tribunal (the “LAT”) related to a motor vehicle collision, which occurred on November 6, 2019. The issues in dispute were: (a) whether the applicant suffered a “minor injury,” in accordance with section 3 of the Statutory Accident Benefits Schedule (the “SABS”); (b) whether the applicant was entitled to psychological services in the amount of $3,841.09; and (c) whether the applicant was entitled to psychological assessment in the amount of $2,486. Additionally, the applicant further sought interest and an award under section 10 of O. Reg 664 due to the insurer unreasonably withholding or delaying payment to the applicant.
In this decision, the Licence Appeal Tribunal (LAT) confirms that, in accordance with the Financial Services Commission of Ontario (FSCO) Superintendent’s Guideline No. 01/18 and Bulletin A-03/18, the hourly rates set out in the Form 1 are only meant to be used for the purposes of calculating monthly entitlement, and the maximum hourly rates are not to strictly apply as the maximum payable for attendant care services.
This case stemmed from a motor vehicle collision in 2010. Three denial letters with respect to Income Replacement Benefits (IRBs) and housekeeping benefits were sent to the insured throughout 2011 but no dispute resolution forms were attached to the last two denials. As part of the FSCO process, the insured applied for mediation which concluded by January 2014 giving the insured an extension of 90 days following the mediator’s report.
The applicant in this case, DC, was involved in a motor vehicle collision on September 20, 2019. DC was 12 years old at the time. As a result of the collision, DC suffered a traumatic brain injury resulting in catastrophic impairment. The dispute before the LAT was whether the respondent, TD Insurance Meloche Monnex, was required to pay DC a non-earner benefit. At the time of the LAT hearing, DC was 15 years old.
The Divisional Court allowed an appeal from a decision of the LAT, finding that the Tribunal’s decision was procedurally unfair
