Gomes v. Economical Insurance, 2022 ONLAT 20-003216/AABS

In an April 19, 2022 decision, Adjudicator Brian Norris denied an Applicant’s request for reconsideration of a ruling which upheld a prior decision that the Applicant was not entitled to the disputed treatment and assessment plans against Economical Insurance Company, the Respondent.

In the prior decision, the Tribunal agreed with the Respondent that the Applicant’s sustained injuries in an automotive accident were minor, and therefore subject to the Minor Injury Guideline as well as the $3,500.00 funding limit on treatment. In response, the Respondent requested reconsideration on the grounds that the Tribunal made an error of law or fact that it would likely have reached a different result had the error not been made, per ground (b) under Rule 18 of the Licence Appeal Tribunal, Animal Care Review Board, and Fire Safety Commission Common Rules of Practice and Procedure.

In review of the Applicant’s submissions, the Adjudicator disagreed with the Applicant, amongst other objections, that there were insufficient reasons to prefer the insurer’s examination report and addendums over the Applicant’s report, stating that it was settled law that the Tribunal is entitled to weigh and favour evidence, with reasons provided in the earlier decision. The Adjudicator ultimately ruled that the Tribunal did not make an error of law or fact, and maintained that the Respondent’s denial of benefits was sufficient and appropriate.