Jacqueline M. Harper

The applicant was injured in a head-on motor vehicle collision, sustaining a severe ankle fracture that developed into progressive post-traumatic arthritis.

He sought post-104 income replacement benefits, funding for three treatment plans, and a special award for unreasonable delay.

The Tribunal found that the applicant was not entitled to post-104 income replacement benefits because he had successfully retrained and was working as a real estate agent, failing to meet the "complete inability" test.

However, the Tribunal approved the disputed treatment plans, finding them reasonable and necessary to manage the applicant's chronic pain and progressive arthritis.

Finally, the Tribunal ordered the respondent to pay a special award of $1,211.40 under s. 10 of O. Reg. 664, finding that the respondent's repeated delays in responding to treatment plans and incorrect demands for repayment constituted excessive and imprudent behavior.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for chiropractic and psychological treatment, which the respondent insurer denied.

The Licence Appeal Tribunal found that the proposed chiropractic treatment and the substantive psychological treatment sessions were reasonable and necessary to achieve maximum recovery, given the applicant's chronic pain and psychological impairments.

However, claims for document preparation and transportation expenses were denied.

The Tribunal also dismissed the applicant's claim for an award for unreasonable delay, finding the insurer acted in good faith, but awarded interest on the overdue benefit payments.

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

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

The Licence Appeal Tribunal found that the applicant suffered from chronic pain with functional impairment and psychological injuries, removing her from the MIG.

The Tribunal ordered the respondent to pay the disputed treatment plans for chiropractic services and a psychological assessment, finding them reasonable and necessary, along with interest on overdue payments.

The applicant was a pedestrian struck by a motor vehicle and sought statutory accident benefits.

The respondent insurer denied four treatment plans for chiropractic, massage, and physiotherapy, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) limit of $3,500.

The respondent also brought a preliminary motion to admit late medical reports, which the Tribunal denied due to non-compliance with a case conference order.

On the substantive issues, the Tribunal found that the applicant sustained a concussion and post-concussion syndrome, which are not defined as minor injuries under the Schedule, thereby removing her from the MIG.

The Tribunal preferred the emergency hospital records diagnosing a concussion over the respondent's insurer examinations conducted months later.

The Tribunal concluded that the four treatment plans totaling over $9,000 were reasonable and necessary to assist the applicant in recovering from her injuries, and awarded interest on the overdue benefits.