Harouna Sidibé

The applicant sought entitlement to several treatment plans for physiotherapy, chiropractic, and psychological services following a motor vehicle accident, as well as an award for unreasonable delay.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the treatment plans were reasonable and necessary.

The Tribunal preferred the respondent's medical evidence, which indicated that further physical therapy would not provide lasting relief and that the applicant's psychological symptoms did not warrant the requested interventions.

Claims for interest and a special award were also dismissed.

The respondent insurer requested a reconsideration of a Licence Appeal Tribunal decision which found that the insured's injuries fell outside the Minor Injury Guideline (MIG) and awarded treatment plans, interest, and a 30% award under s. 10 of Regulation 664.

The insurer argued that the adjudicator erred in fact and law by preferring the evidence of the insured's medical assessor over its own, by finding the insured suffered from chronic pain, and by granting the award.

The Tribunal dismissed the request for reconsideration, holding that the adjudicator made no errors of fact or law but rather properly exercised their jurisdiction to weigh the conflicting medical evidence.

The Tribunal noted that a reconsideration is not an opportunity to re-litigate a party's position or challenge the weight assigned to evidence.

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

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

The Tribunal found that the applicant suffered from accident-related chronic pain syndrome with functional impairment, justifying removal from the MIG.

The Tribunal ordered the respondent to pay for the disputed physiotherapy treatment plans with interest, but denied the applicant's request for a special award under s. 10 of Regulation 664.

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

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

The Tribunal found that the applicant suffered from accident-related psychological impairments and chronic pain, warranting removal from the MIG.

The Tribunal ordered the respondent to pay for a psychological assessment and psychological treatment, finding them reasonable and necessary.

Furthermore, the Tribunal awarded a 30% penalty under section 10 of Regulation 664, concluding that the respondent unreasonably withheld payment by ignoring documented psychological impairments and failing to reconsider its position when new medical evidence became available.