In Calliste v. State Farm Mutual Automobile Insurance Company (2016 ONSC 1854), the insurer brought a summary judgment to dismiss the Plaintiff's claim for medical benefits on the basis that the Plaintiff's injuries were within the Minor Injury Guideline (MIG). The insurer argued that based on the medical evidence, (1) the Plaintiff only suffered minor injuries from the accident and (2) the Plaintiff did not have any pre-existing condition that would prevent him from effectively recovering within the MIG limits. Additionally, the insurer sought summary judgment on the claim for income replacement benefits because the Plaintiff had not provided any evidence that he had lost any income.
The Court referred to the Supreme Court of Canada's decision in Hryniak v. Mauldin (2014 SCC 7) and noted that there were no genuine issues requiring a trial. The Court also referenced the previous decision in Paramandham v.Holmes et al. (2015 ONSC 1903) where summary judgment was granted because no medical evidence was advanced to establish that the injuries fell outside the MIG.
In granting the motion for summary judgment, the Court held that the Plaintiff had not met his burden of proving that he fell outside of the MIG. The Court concluded that there were no inconsistencies between the evidence relied on by the parties. Additionally, the evidentiary record provided the Court with the evidence needed to "fairly and justly adjudicate the dispute." The evidence established that the Plaintiff suffered from a minor injury or predominantly a minor injury which fell within the MIG. Further, the Plaintiff had not adduced the evidence necessary to support his claim for income replacement benefits. The claim was dismissed.
The case serves as an important reminder that applicants, not insurers, have the onus of establishing that a claim falls outside the MIG. While insurers may be reluctant to bring a motion for summary judgment on this issue, the recent case law suggests that with the proper evidentiary record, the court will be prepared to dismiss MIG claims.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
