Brian Norris

The applicant sought statutory accident benefits for psychological injuries allegedly sustained during a road rage incident where third parties struck her vehicle and yelled at her.

The respondent denied benefits on the basis that the incident was not an 'accident' under the Schedule.

The Tribunal applied the two-part purpose and causation test and found that the incident did not arise out of the ordinary use or operation of an automobile.

The Tribunal concluded that the verbal and feared assaults constituted an intervening act that broke the chain of causation.

The application was dismissed.

The applicant insurer sought a preliminary issue hearing to determine if it was required to pay statutory accident benefits to the respondent.

The respondent was injured in a motor vehicle accident while driving a transport truck and was previously found by the Workplace Safety and Insurance Appeals Tribunal to be entitled to claim benefits under the Workplace Safety and Insurance Act (WSIA).

The Tribunal found that under section 61(1) of the Statutory Accident Benefits Schedule, the insurer is not required to pay benefits because the respondent is entitled to WSIA benefits and failed to demonstrate an election to pursue a tort action under section 30 of the WSIA.

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

The insurer denied four treatment plans for chiropractic and massage therapy on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued entitlement based solely on the insurer's alleged failure to provide compliant denial notices under section 38(8) of the Schedule.

The Tribunal found the insurer's denial letters were compliant, as they identified the plans, provided medical reasons, and confirmed the MIG applied.

As the applicant provided no medical evidence to demonstrate her injuries fell outside the MIG, the Tribunal concluded she sustained a minor injury and dismissed the application.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, including a medical benefit for psychological services and income replacement benefits (IRBs).

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

The Licence Appeal Tribunal found that the applicant did not suffer from a chronic pain condition or psychological impairment caused by the accident, and therefore her injuries were subject to the MIG and its $3,500 funding limit.

Consequently, the claim for psychological services was dismissed.

The Tribunal also found that the applicant did not suffer a substantial inability to complete the essential tasks of her pre-accident employment as a warehouse packager, dismissing her claim for IRBs and interest.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits from the respondent insurer.

The respondent denied the claims for chiropractic services and a psychological assessment on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been exhausted.

The applicant argued he suffered from psychological injuries and a chronic pain condition that removed him from the MIG.

The Tribunal found the applicant's evidence insufficient to establish a psychological injury or chronic pain condition, noting he missed no time from work and had minimal medical treatment.

The Tribunal concluded the applicant sustained a minor injury subject to the MIG, dismissed the claims for medical benefits, and denied the requests for interest and an award.

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

The adjudicator found the applicant to be an unreliable witness who misrepresented her post-accident employment status.

The applicant's claim for a chiropractic treatment plan was barred by the two-year limitation period.

The claims for income replacement benefits and other medical benefits were dismissed as the applicant failed to prove she suffered a substantial inability to perform her employment tasks or that the treatments were reasonable and necessary.

Claims for interest and a special award were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to 24/7 attendant care benefits (ACBs) at $6,000 per month due to catastrophic psychiatric impairments.

The respondent insurer approved a lower monthly amount, arguing that 24/7 care was contrary to the recommendations of hospital psychiatrists and would hinder recovery.

The Tribunal found that 24/7 supervisory care was reasonable and necessary, relying on the applicant's treating psychiatrist who noted severe suicidal ideation.

The Tribunal ordered the respondent to pay $15,120 in past incurred ACBs plus interest, but declined to deem further ACBs incurred or order a special award, finding the insurer's reliance on its assessors was not unreasonable.

The Applicant sought statutory accident benefits following a rear-end motor vehicle collision.

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

The Tribunal found that the Applicant failed to prove she suffered from an accident-related psychological injury or chronic pain condition that would remove her from the MIG.

Consequently, the disputed treatment plans were denied as they fell outside the MIG limit.

The Tribunal also dismissed the claim for income replacement benefits, drawing an adverse inference from the Applicant's failure to produce her employment and employment insurance files.

Claims for interest and a section 10 award were also dismissed.

The applicant sought a determination that he sustained a catastrophic impairment under criterion 4 of the Statutory Accident Benefits Schedule following a motor vehicle accident.

The applicant relied on a SPECT scan to demonstrate a traumatic brain injury.

The Tribunal found that a SPECT scan is not a medically recognized brain diagnostic technology, as it is not sufficiently reliable to identify a traumatic brain injury resulting from an accident.

Furthermore, the Tribunal preferred the respondent's radiological evidence, which concluded that the SPECT scan findings were nonspecific and could be explained by other etiologies, such as pre-existing psychological conditions or prior head traumas.

The application was dismissed, and no award for unreasonable delay was granted.

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

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

The Tribunal allowed late-disclosed medical records into evidence, finding them highly relevant and of little prejudice to the respondent.

Based on evidence that the applicant received nerve block injections for ongoing back pain, the Tribunal concluded she suffered from a chronic pain condition and was not subject to the MIG.

However, the Tribunal dismissed the applicant's claims for specific chronic pain, psychological, and physiotherapy treatment plans, finding she failed to demonstrate they were reasonable and necessary.

Claims for an award and interest were also dismissed.

The applicant sought non-earner benefits and funding for various medical and assessment plans following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant suffered a complete inability to carry on a normal life due to psychological impairments, including panic attacks and severe depression, and awarded non-earner benefits.

The Tribunal also approved funding for a biopsychosocial assessment, a chronic pain assessment, and a gym membership with personal training, finding them reasonable and necessary to address the applicant's psychological and minor physical impairments.

Claims for other assessments and an award for unreasonable delay were dismissed.

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

The Respondent denied several treatment plans and prescription expenses.

The Tribunal found that the Applicant was not barred from proceeding to a hearing regarding an occupational therapy plan because the Respondent failed to provide medical reasons for requiring an insurer's examination.

The Tribunal ordered the Respondent to pay for the occupational therapy plan due to its non-compliant response, regardless of the funding limit.

The Tribunal also approved a neuropsychological assessment and certain prescription expenses as reasonable and necessary, but denied an MRI and SPECT scan.

An award of $1,448.86 was granted under section 10 of Regulation 664 for the Respondent's unreasonable withholding of benefits.

The Applicant sought statutory accident benefits following a 2013 motor vehicle accident.

The Tribunal first extended the two-year limitation period under section 7 of the LAT Act, allowing the application to proceed.

On the substantive issues, the Tribunal found the Applicant did not sustain a catastrophic impairment under criterion (f) for mental and behavioural impairments, concluding his limitations were primarily physical due to a herniated disc rather than psychological.

However, the Tribunal found the disputed physiotherapy, chiropractic, and psychological treatment plans to be reasonable and necessary.

The Tribunal also excluded late-filed evidence from the Applicant and rebuttal reports obtained without notice by the Respondent.

The Applicant was awarded interest on overdue payments and a section 10 award of $1,077.43 for the Respondent's unreasonable delay in adjusting the 2017 plans.

No costs were awarded.

The applicant sought statutory accident benefits after being struck by a vehicle during a road rage incident.

The respondent insurer denied the claim, arguing the incident was not an 'accident' because the driver intentionally used the vehicle as a weapon.

The Licence Appeal Tribunal applied the purpose and causation tests, finding that the vehicle was in ordinary use and directly caused the applicant's injuries.

The Tribunal held that the driver's criminal conviction for dangerous driving did not break the chain of causation or disentitle the applicant from benefits, concluding the incident met the definition of an accident under section 3(1) of the Schedule.

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

The insurer denied funding for occupational therapy, physiatry, and neuropsychological assessments, as well as an accountant's report and transportation expenses.

The Licence Appeal Tribunal found that the applicant failed to attend properly scheduled insurer's examinations without a reasonable excuse, barring her from disputing entitlement to the medical assessments.

The claim for the accountant's report was dismissed because the applicant was previously barred from claiming income replacement benefits.

The transportation expenses were denied for failing to address the 50-kilometre deductible.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following an e-bike collision.

The respondent denied the claims, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that she did not suffer a substantial inability to perform the essential tasks of her employment.

The Tribunal found that the applicant failed to prove her injuries warranted removal from the MIG, noting a lack of compelling medical evidence for psychological impairments and relying on insurer's examinations.

The Tribunal also dismissed the claim for income replacement benefits, citing surveillance evidence showing the applicant working and riding a bike.

All claims for medical benefits, attendant care benefits, interest, and an award were dismissed.

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

After the applicant's representative withdrew, the applicant failed to provide updated contact information or respond to the Tribunal's communications.

The applicant did not tender any submissions or evidence for the written hearing.

The Tribunal proceeded in the applicant's absence and dismissed the application, finding the applicant failed to meet her burden of proof.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to non-earner benefits and various medical and assessment plans outside the Minor Injury Guideline (MIG).

The adjudicator found that the applicant's injuries were predominantly minor, noting a lack of persuasive evidence for accident-related psychological, neurological, or chronic pain impairments.

The adjudicator preferred the insurer's medical reports and highlighted inconsistencies in the applicant's self-reporting, including a subsequent cycling accident and surveillance showing her working.

The application was dismissed, with no entitlement to the disputed benefits, interest, or an award.

The Applicant sought various medical, rehabilitation, and attendant care benefits following a motor vehicle accident, as well as an award for unreasonable delay.

The Licence Appeal Tribunal dismissed the application in its entirety.

The Adjudicator found that the Applicant failed to meet her burden of proving that the proposed chiropractic, physiotherapy, psychological, and occupational therapy treatment plans were reasonable and necessary.

The Adjudicator preferred the evidence of the insurer's examination assessors, who found no objective evidence of ongoing musculoskeletal impairment and noted a lack of response to past physical treatments.

Claims for attendant care benefits and an award were also dismissed due to a lack of supporting evidence.

The applicant, who sustained catastrophic injuries in a motor vehicle accident, challenged the incurred expense provisions of the Statutory Accident Benefits Schedule under the Human Rights Code.

She argued that limiting attendant care compensation for non-professional family members to their demonstrated economic loss constructively discriminated against her based on family status and disability.

The Licence Appeal Tribunal dismissed the preliminary issue, finding that the provisions apply universally to all non-professional service providers regardless of their relationship to the insured.

The Tribunal held that the requirement to prove economic loss serves as a threshold to prevent windfalls and does not violate the Code.