Lacroix v. Wawanesa Mutual Insurance, 2021 ONLAT 20-004333 (CanLII) – Case Comment

Learn more about a recent case that illustrates a number of topics I have discussed recently in my blog posts – exceptions to the MIG limits In Lacroix v. Wawanesa Mutual Insurance[1], the Applicant Mr. L had been injured in a motor vehicle accident on January 17, 2017 and applied for statutory accident benefits from Wawanesa Mutual Insurance (“Wawanesa”). The mechanics of the accident was that he was travelling through an intersection facing a green light when a vehicle in the opposing lane of traffic suddenly turned left and collided with his vehicle. In particular, Mr. L claimed: $2,148.93 for…

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Traumatic Brain Injury

Location and Definition A traumatic brain injury (or TBI) is an injury to the brain caused by an external physical force, which can have temporary or permanent cognitive, behavioral and/or physical impairments. The brain consists of the cerebellum, brainstem, corpus collosum and four lobes (frontal, temporal, parietal and occipital). Function The frontal lobe is responsible for motor planning, motor movement, executive functions, personality and memory. The parietal lobe is responsible for goal-directed voluntary movement, spatial and touch perception, visual attention and perception, integration of sense and manipulation of objects. The temporal lobe is responsible for understanding language, sequencing, organization, memory…

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Procedural Fairness in LAT Proceedings

Find out about some examples where an insurance company failed to meet the minimal requirements of fairness Lockyear v. Wawanesa Mutual Insurance Company[1] is a recent case where an appeal to the Superior Court of Justice, from a decision of the License Appeal Tribunal (LAT) rejecting the insured’s application to be designated as catastrophically impaired, was granted on the basis that the LAT hearing and reconsideration breached the duty of procedural fairness. Procedural fairness is recognized by the courts as a central principle of Canadian administrative law. Procedural fairness refers to the right to be heard, for someone to participate…

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Spinal Injuries

Location and Definition The spine consists of 33 vertebrae (or bones) and runs from the base of the skull to the tailbone (called the coccyx). It is divided into five functional areas: cervical spine, thoracic, lumbar, sacral and coccygeal. Function The spinal cord transmits motor information from the brain to the muscles and transmits sensory information from the skin, joints etc. to the brain. The spinal cord can also produce responses (called reflexes) by receiving sensory messages and sending motor messages without any input from the brain. Injuries The spinal cord can be injured at any point along its axis.…

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Skateboard Safety in Malls

An interesting recent case One’s personal safety can be affected in many ways at malls – accidentally being run into by people not paying attention, slipping on wet floors and tripping on objects brought into the mall by patrons. Here, we examine a case, called Drummond v. Cadillac Fairview Corp., where a man tripped over a skateboard in the food court and sued the mall-owner for occupier’s liability. First instance[1] The plaintiff was having something to eat at the food court with his daughter and fiancé. When he went to get a refill of his drink, he tripped over a…

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Escaping the MIG – Reasonable and Necessary – Two Recent Cases

Exploring some examples involving the reasonable and necessary requirement Section 3 of the Statutory Accident Benefits Schedule (“SABS”) defines a minor injury as “one or more of a sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation and includes any clinically associated sequelae to such an injury”.[1] Subsection 18(1) of SABS provides that the sum of the medical and rehabilitation benefits payable in respect of an insured person who sustains an impairment that is predominantly a minor injury shall not exceed $3,500.[2] However, subsection 18(2) provides that, despite subsection 18(1), the limit in that subsection does not apply to…

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When is a car incident a car accident?

Learn about a preliminary (or threshold) issue in a statutory accident benefits case In a statutory accident benefits case, there is always a preliminary (or threshold) issue as to whether the incident in question is, technically, an accident. An “accident” is defined in the legislation as follows[1]: “accident” means an incident in which the use or operation of an automobile directly causes an impairment or directly causes damage to any prescription eyewear, denture, hearing aid, prosthesis or other medical or dental device; (“accident”) Satisfying this legal definition is broken down into three distinct sub-issues or questions: Was the vehicle involved…

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Consumer Fraud and Protection

1- Intro Consumer protection law is an important area of the law that provides minimal protections to consumers, given the inequality of power that exists between suppliers and consumers of goods and services. Historically, consumer protection law was a part of the judge-made common law; however, in Ontario it is now codified in a piece of legislation entitled the Consumer Protection Act, 2002 (“CPA, 2002”). A consumer agreement is defined in the Act as an agreement between a supplier and a consumer in which, the supplier agrees to supply goods or services for payment, or the supplier agrees to provide…

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What if my injuries interfere with my domestic duties?

Reimbursement for where injured persons need to hire services for care or housework 1- The Caregiver Benefit (CGB) The caregiver benefit (or CGB) can be available if the injured person was a stay-at-home parent or caregiver at the time of the MVA, and now requires third-party services to take over their caregiving tasks. The benefit can help reimburse the injured person for the reasonable and necessary costs of these services. The housekeeping and home maintenance benefits (HKBs and HMBs) can be available to help reimburse an injured person for reasonable and necessary expenses of hiring a third party to do…

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Enhanced Auto Insurance Coverage

Learn about some extra benefits available to be purchased at the time of entering into a policy At the time of entering into an insurance contract, the insurance provider is obligated to give the consumer information about optional benefits.[1] Optional benefits provide enhanced coverage. They can only be purchased in relation to an accident before the accident occurs.[2] The optional benefits, governed by s. 28 of the Statutory Accident Benefits Schedule (or “SABS”), a regulation made under the Insurance Act, R.S.O. 1990, c.I.8, are applicable only to: the named insured, the spouse of the named insured; the dependents of the…

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