E. Louise Logan

The applicant sought a medical benefit for chiropractic services following a motor vehicle accident.

The respondent denied the treatment plan on the basis that it was submitted during a period when the applicant was entitled to treatment under the Minor Injury Guideline (MIG).

The Tribunal found that the respondent was permitted to refuse the treatment plan under s. 38(5) of the Schedule and that this refusal was final and not subject to review under s. 38(6).

Furthermore, the applicant failed to provide compelling medical evidence to demonstrate that the chiropractic services were reasonable and necessary.

The application was dismissed, and claims for a section 10 award and interest were also denied.

The respondent insurer requested a reconsideration of a preliminary decision which found that the applicant's dispute for income replacement benefits was not statute-barred.

The Tribunal originally held that the limitation period did not begin until the denial notice was delivered to the applicant's counsel.

On reconsideration, the Vice-Chair found this to be an error of law, as section 64 of the Schedule does not require re-delivery of a valid notice to counsel retained after the initial delivery.

The reconsideration was granted, and the applicant's claim was found to be statute-barred.

The applicant requested a reconsideration of a Tribunal order requiring her to pay $1,000 in costs to the respondent after she withdrew her application.

She argued the Tribunal lacked jurisdiction because the file was closed and that it violated procedural fairness by not issuing a separate Notice of Hearing for the costs request.

The Tribunal denied the reconsideration, finding that the respondent made the costs request orally at the scheduled videoconference hearing before the file was closed, giving the Tribunal jurisdiction.

Furthermore, the applicant had adequate notice and an opportunity to provide written submissions on costs, satisfying procedural fairness requirements.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found his injuries fell within the Minor Injury Guideline.

The applicant argued the Tribunal erred in law by requiring him to meet the definition of permanent serious impairment.

The Vice-Chair dismissed the request, finding that the original decision did not reference or apply the permanent serious impairment test, and the applicant failed to establish any error of law that would have changed the result.

The respondent insurer requested a reconsideration of a preliminary issue decision which found that the exclusion under s. 31(1)(a)(i) of the Statutory Accident Benefits Schedule did not apply to the applicant.

The respondent argued the Tribunal made an error of law by applying a subjective test rather than an objective test to determine whether the applicant knew or ought reasonably to have known he was operating his motorcycle without liability insurance.

The Vice-Chair agreed, finding that the Tribunal erred in law by applying a subjective test.

Applying the correct objective test, the Vice-Chair concluded that an ordinary, rational person with the applicant's background ought reasonably to have known the motorcycle was uninsured.

The request for reconsideration was granted, and the applicant's claim was found subject to the exclusion.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied an award under section 10 of Regulation 664 for unreasonably withholding benefits.

The applicant argued the Tribunal failed to consider submissions, failed to apply facts to the legal test, and erred in finding the respondent reasonably relied on its medical professionals and surveillance evidence.

The Vice-Chair dismissed the request, finding no breach of procedural fairness or error of law that would have likely affected the outcome of the decision.