IMPORTANT CASES

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Economical and ICBC
2017-04-19
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An important priority arbitration decision confirming adult children in full time post secondary eduation are usually dependent upon their parents absent unusual circumnstances where they earn enough income or have the financial means to cover at least 50% of their cost of living. This decision follows the existing caselaw setting out that loans and lines of credit for school are not considered income in the hands of the student, but rather debts, and are therefore neutral in the dependency analysis (to the extent that the loan or line of credit is used for school expenses).
Laches Does Not Apply to Loss Transfer Claims
2015-11-12
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In Intact Insurance Company of Canada v. Lombard General Insurance Company of Canada, 2015 ONCA 764, the Court of Appeal recently confirmed that the equitable doctrine of laches does not apply to loss transfer claims. This means that there is no legislated limitation period for loss transfer indemnification claims made after January 1, 2004 (yes, 2004). As result of this decision, the legislature may take steps to amend O. Reg. 668 to include a limitation period for the service of a Notice of Loss Transfer and perhaps a two year limitation period to serve a Loss Transfer Request for Indemnification from the date that the underlying accident benefits claim exceeds the $2,000 deductible. In the meantime, insurers will initiate and respond to further "stale dated" claims for loss transfer.
ONCA Confirms Absurdity of Superior Court's Rule 9 Interpretation
2015-10-20
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With a unanimous 3-0 decision, the Court of Appeal confirms that heavy commercial vehicle insurers only pay loss transfer to insurers of vehicles with which they actually collide under Rules 9 and 11 of the Fault Determination Rules.
EUO: Still a hammer in the tool box
2015-07-17
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The now infamous December 5, 2014 Williams and State Farm Preliminary Issue Motion Decision found that s. 36(4) prohibits a s. 33 examination under oath for specified benefits if it is not requested within 10 days of the insurer's receipt of the OCF-1 and the OCF-3. The Appeal Decision(FSCO Appeal P15-00001)confirms that an EUO is permitted at any time to address past, present or future benefits.
Unifund and TD
2015-07-14
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Arbitrator Novick confirmed that a 60 year old visitor to Canada was principally dependent for finances upon her daughter, the spouse of TD's named insured.
Bustamante v. The Guarantee Company of North America, 2015 ONCA 530 (CanLII)
2015-07-08
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Court of Appeal decision confirming that a retroactive non-earner benefit re-election was barred due to the expiry of the limitation period.
T.N. and Personal (FSCO A06-000399)
2014-11-20
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A landmark decision dealing with a delayed retroactive claim for Attendant Care Benefits and a precedent setting award of interest and a Special Award.
TD v. Markel, 2014 ONSC 6461 (CanLII)
2014-11-12
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A unique precedent and successful Loss Transfer Appeal confirming that an insurer who fails to properly transfer priority for an accident benefits claim cannot claim loss transfer.
Singh and State Farm (FSCO A12-007594)
2014-08-22
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The Applicant's failure to comply with s. 33 resulted in a stay of the Arbitration proceeding to allow the completion of an EUO. No benefits were payable during the period of non-compliance and if the Applicant failed to attend the EUO within 90 days, the Arbitration would be dismissed.
Zurich Insurance Company v. Chubb Insurance Company of Canada, 2014 ONCA 400 (CanLII)
2014-05-15
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Juriansz J.A.'s insightful dissent confirming that a motor vehicle liability insurer in Ontario is obligated to respond to a claim for accident benefits and then initiate a priority dispute was affirmed by the Supreme Court of Canada on April 21, 2015 in Zurich Insurance Co. v. Chubb Insurance Co. of Canada, 2015 SCC 19 (CanLII).
Lo-Papa and Certas Direct (FSCO A12-005538)
2014-05-14
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FSCO decision confirming the onus is on the insured person to prove that their impairments are not predominantly minor in nature in order to be entitled to medical and rehabilitation benefits outside of the MIG and the hard cap of $3,500.
Djermanovic v. Mckenzie, 2014 ONSC 1335 (CanLII)
2014-02-28
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This threshold decision revisits the interplay between the judge and jury's findings regarding damages and the threshold. The plaintiff’s credibility was seriously in issue and, due to the subjective nature of the plaintiff's complaints consisting of soft tissue injuries, primarily to his upper back, headaches and PTSD, depression and anxiety, it was of primary importance to his case. The jury awarded $10,000 in general damages. Justice Broad similarly concluded the threshold was not met and the action was dismissed.
Hansen v. Williams, 2014 ONCA 118 (CanLII)
2014-02-10
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The Court of Appeal declined to reverse or otherwise intervene on the appeal of a jury's non-pecuniary damages award of $200,000 for "thoracic outlet syndrome".

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