Brian Norris

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

The insurer denied certain treatment plans and income replacement benefits (IRBs), arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's soft-tissue injuries were predominantly minor and that his reported chronic pain did not cause a functional impairment sufficient to remove him from the MIG.

Consequently, the disputed treatment plans were denied as they exceeded the MIG funding limit.

While the applicant qualified for IRBs, the claim was dismissed because he failed to provide sufficient financial documentation to calculate the quantum of the benefit.

The applicant sought an award under section 10 of O. Reg. 664, alleging the respondent unreasonably delayed or withheld payment of a benefit by failing to provide a response to a psychological treatment plan.

The respondent admitted to making administrative errors in sending the approval to the wrong fax number and email address.

The Tribunal dismissed the application, finding that while the respondent made errors, there was no evidence that payment of a benefit was unreasonably withheld or delayed, as the applicant had not incurred any of the goods or services listed in the treatment plan.

The applicant requested a reconsideration of a decision finding that her injuries fell within the Minor Injury Guideline (MIG) and denying her disputed treatment and assessment plans.

The applicant argued the adjudicator made errors of fact and law, misapprehended evidence, and provided insufficient reasons.

The adjudicator found no significant errors of law or fact that would have changed the outcome, noting that the insurer's denials complied with section 38 of the Schedule.

The request for reconsideration was denied.

The applicant requested a reconsideration of a decision finding her injuries fell within the Minor Injury Guideline (MIG) and denying her disputed treatment plans.

The adjudicator dismissed the request, finding it was filed 17 days past the 21-day deadline without a valid explanation.

Furthermore, the adjudicator refused to admit a new rebuttal report from the applicant's specialist, noting it could have been obtained prior to the initial hearing and its admission would be procedurally unfair.

Finally, the adjudicator found no error of law or fact in the original causation analysis.

The applicant sought statutory accident benefits following a motor vehicle accident where he was allegedly struck as a pedestrian.

The insurer determined his injuries fell within the Minor Injury Guideline (MIG) and denied further treatment plans and Income Replacement Benefits (IRBs).

The Tribunal found that the applicant failed to prove his injuries fell outside the MIG, rejecting his claims of chronic pain and psychological injuries due to inconsistent medical evidence and uncompelling expert reports.

The Tribunal also dismissed the claim for IRBs, finding no credible link between the accident and the applicant's inability to work, as the medical evidence showed functional range of motion and no substantial impairment.

All claims were dismissed.

The Applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs) and various treatment and assessment plans.

The Licence Appeal Tribunal found that the Applicant was not substantially unable to perform the essential tasks of her employment, noting her successful completion of post-secondary courses and field placements, and dismissed the claim for IRBs.

The Tribunal also dismissed most of the claims for treatment and assessment plans, finding them not reasonable and necessary, except for the unapproved balance of a psychological assessment plan.

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

The applicant sought reconsideration of a Licence Appeal Tribunal decision which found he had not established on a balance of probabilities that he was struck by a vehicle.

The applicant argued the adjudicator violated procedural fairness by finding him credible but still dismissing the claim, and made errors of law in weighing medical and police records.

The Tribunal dismissed the request for reconsideration, holding that credibility is distinct from reliability and does not automatically discharge the burden of proof.

The Tribunal found no error in the original assessment that the corroborating evidence was insufficient to prove an accident occurred.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits.

The insurer denied several treatment and assessment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant sustained psychological injuries that removed her from the MIG.

The Tribunal ordered the insurer to pay for the disputed psychological, physiotherapy, and chronic pain assessments and treatments, finding them reasonable and necessary.

The applicant's claim for an award under Regulation 664 was dismissed because the insurer reasonably relied on its assessors' reports.

The applicant was injured in a rear-end motor vehicle collision and sought statutory accident benefits.

The insurer determined the injuries fell within the Minor Injury Guideline (MIG) and denied funding for two physiotherapy treatment plans.

The applicant argued he sustained a concussion and chronic pain, removing him from the MIG.

The Tribunal found the medical evidence, including hospital records and employment records, did not support a non-minor injury diagnosis.

The applicant was held to the MIG limit, which was already exhausted, and his claims for the treatment plans, an award, and costs were dismissed.

The applicant, a pedestrian struck by a vehicle, sought statutory accident benefits for a catastrophic impairment assessment plan.

The respondent insurer partially approved the plan but denied funding for clinic file reviews, transportation fees, and a form fee, arguing they exceeded the $2,000 cap under section 25(5) of the Statutory Accident Benefits Schedule.

The Tribunal found that file review fees and form fees are included within the $2,000 assessment cap.

The Tribunal also found no evidence to support the claim for transportation expenses.

The application was dismissed.

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

The respondent raised a preliminary issue, arguing the application was barred by res judicata because a previous Tribunal decision found the applicant sustained no impairments as a result of the accident.

The Tribunal agreed, finding all four preconditions for res judicata were met and no fresh evidence was provided to impeach the initial finding.

The application was dismissed.

The applicant, a minor, was injured in a motor vehicle accident and sought statutory accident benefits for chiropractic treatment.

The respondent insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and she had exhausted the $3,500 funding limit.

The applicant argued she should be removed from the MIG due to pre-existing knee issues, chronic pain, and psychological symptoms.

The Tribunal found insufficient evidence to support removal from the MIG, noting the applicant's return to full-time school and sports, and the lack of a chronic pain diagnosis or psychological treatment.

The application was dismissed.

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

The insurer denied IRBs for the period prior to the submission of a disability certificate (OCF-3).

The applicant argued the insurer failed to provide the OCF-3 as required by section 32(2) of the Schedule, and thus could not rely on section 36(3) to deny benefits.

The Tribunal held that section 36(3) strictly disentitles an applicant to IRBs for any period before the certificate is submitted, regardless of the insurer's failure under section 32(2).

Claims for interest and a special award were also dismissed because no benefits were overdue or payable.

The applicant was injured in a motor vehicle accident and sought funding for a physiatry assessment.

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

Although the applicant was later removed from the MIG due to psychological injuries and chronic pain, the Tribunal found the physiatry assessment was not reasonable and necessary.

The assessment was proposed over two years before the chronic pain diagnosis, at a time when treating physicians only recommended physiotherapy.

Furthermore, the Tribunal found the proposed assessment would be duplicative of a chronic pain assessment already completed by the applicant's own medical expert.

The application was dismissed.

The applicant requested a reconsideration of a decision barring him from proceeding with his application for accident benefits due to his failure to attend an insurer's examination (IE).

The applicant argued the adjudicator erred in law by failing to properly consider whether the insurer made reasonable efforts to schedule the IE at a convenient time, and violated natural justice by attributing delay to him rather than the Tribunal.

The adjudicator dismissed the request, finding no error of law or fact, as the insurer had rescheduled the IEs and the applicant never communicated any scheduling conflicts.

The adjudicator also found no violation of natural justice, noting the delay caused incurable prejudice to the insurer.

The Applicant was struck by a vehicle in a parking lot, sustaining a right knee sprain and psychological injuries.

She also had a pre-existing hip condition that required surgery.

The Tribunal found that the accident did not cause or accelerate the need for hip surgery, but did cause chronic knee pain that prevented her from working.

The Applicant was awarded income replacement benefits, physiotherapy, and psychological treatment.

Claims for attendant care benefits and occupational therapy related to her hip surgery were dismissed, as was her claim for a special award.

The applicant requested a reconsideration of a decision denying a chiropractic treatment plan following a motor vehicle accident.

The applicant argued the adjudicator violated procedural fairness, made errors of law and fact by preferring the insurer's examination over the treating doctor's reports, and sought to introduce new medical evidence.

The adjudicator dismissed the request, finding no breach of procedural fairness, no error of law or fact that would have changed the outcome, and that the new evidence was obtained after the decision and would not have altered the result.

The Applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to income replacement benefits (IRBs), various medical benefits for treatment and assessment plans, an award, and interest.

The Licence Appeal Tribunal dismissed the application.

The adjudicator found that the Applicant failed to meet the minimum employment threshold to qualify for IRBs, as there was insufficient evidence she was employed at the time of the accident or for 26 of the 52 weeks preceding it.

Furthermore, the disputed treatment and assessment plans were deemed not reasonable and necessary, as they were unsupported by compelling medical evidence.

Claims for an award and interest were also dismissed.

The applicant was severely injured when the ATV he was driving collided with a dirt bike on private property.

He sought statutory accident benefits from the respondent insurer, who denied the claim on the basis that the incident did not meet the definition of an "accident" under the Schedule because neither vehicle was an "automobile".

The Tribunal found that the owner of the ATV was not an occupier of the private property where the collision occurred.

Consequently, the ATV was required to be insured under section 15 of the Off-Road Vehicles Act, bringing it within the definition of an "automobile" under the Insurance Act.

The Tribunal concluded that the incident was an "accident" and the applicant was entitled to claim benefits.

The applicant, who sustained a catastrophic impairment in a snowmobile accident, sought various statutory accident benefits including attendant care benefits (ACBs), medical benefits, and home modifications.

The Licence Appeal Tribunal determined the applicant was entitled to ongoing ACBs at a reduced rate of $2,958.86 per month.

The Tribunal also approved funding for a hydraulic lift table, cognition therapy, a remote car starter, and a printer, finding them reasonable and necessary for rehabilitation and independence.

However, claims for a whirlpool tub, noise-cancelling headphones, leisure tickets, an automated generator, and a $33,309 home modification assessment were denied.

The home modification claim was dismissed because it failed to provide a full costing, depriving the insurer of its statutory right to weigh the cost against purchasing a new home.