Blaine Baker

The applicant sought reinstatement of income replacement benefits that were suspended by the respondent insurer after the applicant failed to provide requested medical documentation.

The Tribunal found that the insurer was entitled to suspend benefits under section 33(6) of the Schedule during the period of non-compliance.

However, because the applicant eventually provided the requested disability certificate and evidence of ongoing treatment on March 24, 2017, the Tribunal ordered the insurer to recommence payment of the benefits from that date.

The applicant sought statutory accident benefits following a motor vehicle accident, including ongoing non-earner benefits and two physiotherapy treatment plans.

The insurer had paid non-earner benefits for six months but sought to retroactively terminate them, while also denying the treatment plans.

The Licence Appeal Tribunal found that the applicant did not meet the test for ongoing non-earner benefits after November 2015, given her level of post-accident activity, but refused to retroactively terminate the benefits already paid.

The Tribunal granted the two physiotherapy treatment plans, finding them reasonable and necessary due to the close connection between the applicant's physical pain and her psychological conditions, including post-traumatic stress disorder and depression.

The applicant suffered a fractured elbow in a bicycle accident and sought payment for a $2,912.00 orthopaedic assessment under the Statutory Accident Benefits Schedule.

The insurer denied the claim, arguing the assessment was not reasonable and necessary and exceeded the $2,000.00 cap.

The Tribunal found the assessment was reasonable and necessary, noting the cap did not apply to the entire amount as it included recoverable travel and preparation expenses.

The Tribunal ordered the insurer to pay the assessment cost with interest, but denied the applicant's requests for costs and a special award for unreasonable delay.

The applicant sought statutory accident benefits following a motor vehicle accident.

After failing to attend an initial case conference, the applicant and his counsel failed to attend the reconvened case conference despite being warned that failure to appear could result in dismissal.

The respondent moved to dismiss the application.

The adjudicator granted the motion and dismissed the application for abandonment under Rule 3.4 of the Licence Appeal Tribunal Rules of Practice and Procedure.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a job demands analysis.

The respondent insurer denied the treatment plan, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant's injuries were not predominantly minor, relying on medical evidence of a labral tear and a pre-existing C7 nerve root condition that would prevent maximal recovery under the MIG.

The Tribunal ordered the respondent to pay the remaining balance of the treatment plan and interest on the overdue payment, but denied the applicant's request for costs.