Brian Norris

The applicant was injured in a motor vehicle accident and sought medical benefits for psychological and neurological assessments.

The respondent insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and its $3,500 funding limit.

The Licence Appeal Tribunal found that the applicant did not sustain a concussion, psychological injury, or chronic pain as a result of the subject accident, noting that any ongoing symptoms were likely attributable to a subsequent accident.

The Tribunal concluded the applicant sustained a minor injury subject to the MIG, dismissed the claims for the disputed assessment plans, and denied claims for an award and interest.

The applicant insurer sought repayment of $3,488.92 in medical and rehabilitation benefits paid to the respondent, alleging wilful misrepresentation.

In a prior hearing, the Tribunal determined the respondent was not a passenger in the vehicle involved in the subject accident.

The adjudicator found the respondent committed wilful misrepresentation by falsely claiming to be in the accident.

The adjudicator also found the insurer's repayment notices were sufficient, despite improperly including claims for insurer's examination expenses.

The respondent was ordered to repay $3,488.92 plus interest.

The applicant sought non-earner benefits and medical benefits following a motor vehicle accident.

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

The Tribunal found that the applicant sustained a minor injury and did not suffer a complete inability to carry on a normal life.

However, because the insurer failed to comply with the notice provisions under sections 36 and 38 of the Schedule, the applicant was awarded non-earner benefits for the period of non-compliance (January 18 to April 30, 2019) and an attendant care assessment plan incurred during the period of non-compliance.

The remaining assessment plans were denied as not reasonable and necessary, and the claim for an award was dismissed.

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

The Respondent denied claims for attendant care benefits, an accounting report, various treatment plans, and prescription cannabis.

The Tribunal found that the attendant care benefits were not incurred and the accounting report was not reasonably required.

The disputed treatment plans were found not reasonable and necessary, largely based on uncontroverted insurer's examination reports indicating the Applicant had reached maximum medical recovery or that further facility-based treatment was not supported.

The Respondent agreed to pay for one treatment plan and the incurred prescription cannabis expenses.

The claim for an award for unreasonable delay was dismissed.

The applicant sought medical benefits and income replacement benefits following a motor vehicle accident.

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

The Tribunal found that the applicant sustained predominantly soft tissue injuries and did not suffer from chronic pain or an accident-related psychological injury.

Consequently, the applicant was subject to the MIG and not entitled to the disputed treatment plans.

The claim for income replacement benefits was also dismissed because the applicant failed to submit a disability certificate prior to the claimed period.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming a catastrophic impairment and entitlement to medical benefits for an in-home assessment and an in-patient addiction treatment program.

The applicant passed away shortly after the hearing, rendering the catastrophic impairment issue moot.

The Tribunal found that the applicant's polysubstance abuse disorder was directly caused by the accident due to the prescription of opioid medication for accident-related pain.

The Tribunal granted the $21,450.00 treatment plan for the addiction centre as reasonable and necessary, but denied the $1,709.45 assessment plan because it was incurred before submission.

The claim for an award under Regulation 664 was dismissed as the insurer's position was not unreasonable.

The Applicant sought statutory accident benefits following a 2010 motor vehicle accident, claiming entitlement to attendant care benefits of $6,000 per month, extensive home modifications, and alternative housing.

The Tribunal found the Applicant entitled to attendant care benefits up to $3,589.07 per month based on her mental and behavioural impairments, but noted no expenses had been incurred to date.

The claims for home modifications and alternative housing were dismissed, as the Applicant's physical impairments did not warrant them and her primary challenges were related to disorganization and clutter.

The Tribunal also found the housing assessment was subject to the $2,000 funding limit.

The Applicant was awarded $1,000 in costs due to the Respondent's failure to provide a timely copy of the hearing transcript and for exceeding submission page limits.

The Applicant, a pedestrian struck by a vehicle, sought non-earner benefits and funding for a catastrophic impairment assessment from her insurer.

The Licence Appeal Tribunal dismissed the application, finding the Applicant failed to prove she suffered a complete inability to carry on a normal life.

The Tribunal gave no weight to the Applicant's medical reports due to inconsistencies and failure to address pre-existing conditions from a prior accident.

Conversely, the insurer's examination reports, which found no residual impairment, were accepted.

The request for a catastrophic impairment assessment was also denied as not reasonable and necessary.

The Applicant sought income replacement benefits (IRBs) following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the Applicant failed to prove she suffered a substantial inability to perform the essential tasks of her employment.

The Tribunal noted the lack of evidence regarding her essential work tasks and found the medical evidence, including an occupational therapy report lacking objective functional assessments, insufficient to establish a disabling impairment.

Claims for a Regulation 664 award and interest were consequently dismissed.

The applicant was involved in a motor vehicle accident and sought income replacement benefits (IRBs) beyond the 104-week mark.

The respondent insurer terminated the benefits, relying on surveillance evidence of the applicant playing video games for extended periods and an assessment suggesting he could work in sedentary roles.

The Tribunal found that the applicant suffered from a mild traumatic brain injury and lumbar radiculopathy, which completely impaired his ability to engage in suitable employment.

The Tribunal rejected the respondent's reliance on the video game surveillance, noting that gameplay does not equate to competitive employability in a real-world setting.

The applicant was awarded ongoing IRBs and interest, but his claim for a special award for unreasonable withholding of benefits was dismissed.

The applicant sought non-earner benefits and medical benefits for physiotherapy following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant failed to meet her onus to demonstrate a complete inability to carry on a normal life, as she provided no pre-accident documentation to compare with her post-accident abilities.

The Tribunal also determined that the applicant's injuries were predominantly minor sprains and strains, subject to the Minor Injury Guideline limit, and dismissed the claims for treatment plans as they were not submitted for the hearing.

The applicant sought a determination that she sustained a catastrophic impairment due to a mental or behavioural disorder following a motor vehicle accident.

The adjudicator found that the applicant's pre-existing physical and cognitive conditions, including brain lesions and diabetes, were the primary cause of her functional limitations.

The adjudicator rejected the applicant's psychiatric expert evidence, finding it overstated her pre-accident functioning and improperly conflated physical and mental impairments.

The application was dismissed, as the applicant failed to demonstrate a marked impairment in three or more domains of function.

The applicant sought reconsideration of a decision denying him income replacement benefits beyond 104 weeks post-accident.

The applicant argued the adjudicator made errors of fact and law regarding his pre- and post-accident employment, medical restrictions, and the legal test for post-104 IRBs.

The tribunal found no errors of fact, noting the applicant returned to work at a reduced capacity and failed to provide medical evidence restricting him from working full-time.

The tribunal also found no error of law, as the adjudicator properly assessed the applicant's disability and employment competencies in a real-world setting.

The request for reconsideration was denied.

The applicant was injured in a motor vehicle accident and sought non-earner benefits and various medical benefits from the respondent insurer.

The insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant failed to prove his injuries fell outside the MIG, as there was insufficient evidence of pre-existing conditions, psychological injuries, or chronic pain that would preclude his recovery within the MIG limits.

The Tribunal also dismissed the claim for non-earner benefits, finding the applicant returned to work and continued his normal activities.

The application was dismissed.

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

The respondent denied several treatment and assessment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued he sustained psychological impairments that removed him from the MIG.

The Tribunal found the applicant's evidence uncompelling, preferring the respondent's insurer's examinations which concluded the applicant suffered no significant physical or psychological impairments as a result of the accident.

The Tribunal held the applicant sustained a predominantly minor injury and was subject to the $3,500 funding limit.

As the disputed plans exceeded this limit, the claims were dismissed.

The applicant was involved in a motor vehicle accident in Michigan and elected to receive benefits under Michigan law from his Ontario insurer.

The insurer later discovered the applicant had failed to disclose a prior at-fault accident and a cancelled insurance policy on his application, and terminated his income replacement benefits (IRBs) due to material misrepresentation.

The Licence Appeal Tribunal found that the applicant made material misrepresentations that induced the insurer to enter into the contract.

The Tribunal held that the applicant was excluded from receiving IRBs under section 31(1)(b) of the Schedule, and that this exclusion applied even though he had elected to receive Michigan Work Loss Benefits.

Alternatively, the Tribunal found the applicant would be disqualified under Michigan common law.

The applicant was ordered to repay $72,881.74 in benefits paid, plus interest.

The applicant sought income replacement benefits (IRBs) for psychological injuries sustained while caring for her spouse, who was catastrophically injured in a motor vehicle accident.

The insurer raised a preliminary issue that the claim was barred because the applicant failed to apply within 104 weeks of the accident.

The Tribunal found that while the applicant was generally barred from claiming IRBs because her impairment arose more than 104 weeks after the accident, the insurer's failure to respond to her application within the mandatory 10-day period under section 36 of the Schedule entitled her to IRBs for the period between her application and the insurer's eventual response.

The applicant sought statutory accident benefits, including attendant care benefits, following the death of her husband in a motor vehicle accident.

The insurer requested that the applicant attend psychological and occupational therapy insurer's examinations (IEs) to assess her entitlement.

The applicant failed to attend the scheduled IEs, arguing the notices were deficient and the examinations were not reasonably necessary.

The Tribunal found the insurer's notices complied with section 44 of the Schedule and the requests were reasonable.

Consequently, the Tribunal held the applicant was barred from proceeding with her application for attendant care benefits and a related assessment plan pursuant to section 55(1)2 of the Schedule.

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

The respondent determined the applicant sustained a minor injury, subjecting her to the Minor Injury Guideline (MIG) and its $3,500 funding limit, and denied her claims for non-earner benefits and certain treatment plans.

The Tribunal found that the applicant's injuries were predominantly minor soft-tissue injuries and that her pre-existing chronic pain and psychological issues were not materially exacerbated by the accident.

The Tribunal preferred the respondent's expert evidence, which incorporated a review of pre-accident medical records, over the applicant's experts who relied solely on self-reporting.

The application was dismissed, as the applicant failed to prove her injuries fell outside the MIG or that she suffered a complete inability to carry on a normal life.

Both parties requested reconsideration of a decision regarding entitlement to statutory accident benefits following a motor vehicle accident.

The Applicant argued the Tribunal violated procedural fairness by admitting college records and failing to address a costs request, and made errors of fact and law in weighing medical evidence.

The Respondent argued the Tribunal erred in its interpretation of the Schedule regarding assessment fee limits.

The Tribunal granted the Applicant's request in part to address the omitted costs request, which was ultimately denied, and dismissed all other grounds for reconsideration, finding no significant errors of law or fact that would have changed the outcome.