Janet Hueglin Hartwick

The applicant requested a reconsideration of a previous Licence Appeal Tribunal decision that denied a special award under section 10 of Regulation 664 for the cost and modification of a new home.

The applicant argued the adjudicator made an error of law or fact by not granting the award despite finding the respondent's denial unreasonable.

The adjudicator dismissed the reconsideration request, finding no error of law or fact, as the applicant failed to provide the necessary evidence regarding the cost of modifying the pre-accident home to calculate the quantum of the award.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs).

The respondent denied the benefits, arguing the applicant's post-accident business results from his flooring company offset his entitlement.

The Tribunal found that the applicant was paid as an employee, not a shareholder, and preferred the applicant's accounting report.

The Tribunal ordered the respondent to pay IRBs of $400.00 per week from March 17, 2020, ongoing, plus interest.

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits under the Statutory Accident Benefits Schedule.

The insurer denied treatment plans for physiotherapy and an in-home occupational therapy assessment.

The Licence Appeal Tribunal found the first physiotherapy treatment plan was reasonable and necessary, as the applicant's condition had regressed when treatment was paused during the COVID-19 pandemic.

However, the Tribunal dismissed the claims for the occupational therapy assessment and a subsequent physiotherapy plan, finding insufficient medical evidence to support them.

The applicant's claim for an award for unreasonable delay was also dismissed.

The applicant, who sustained a catastrophic impairment in a motor vehicle accident, sought attendant care benefits (ACB) of $4,339.71 per month and assistive devices.

The respondent insurer had reduced her ACB to $1,040.10 per month.

The Tribunal found that the applicant's claim was not statute-barred because the insurer failed to provide proper medical reasons for its refusal, meaning the limitation period had not commenced.

On the merits, the Tribunal accepted the applicant's need for daytime cueing and mobility assistance but rejected the need for nighttime supervisory care, awarding ACB at $1,630.72 per month.

The Tribunal declined to deem the expenses incurred, as the insurer had paid all submitted invoices and did not unreasonably delay payment.

Claims for assistive baby devices and a special award under Regulation 664 were dismissed.

The applicant, who sustained a catastrophic impairment in a motor vehicle accident, sought statutory accident benefits.

Prior to the hearing, the respondent insurer approved the disputed treatment plans for accessible housing, a wheelchair accessible vehicle, and attendant care benefits.

The hearing proceeded on the issue of whether the respondent was liable for a special award under s. 10 of O. Reg. 664 for unreasonably withholding or delaying these benefits.

The Tribunal found the respondent's handling of the file was inflexible, imprudent, and unyielding, particularly given the applicant's extreme vulnerability and access to optional benefits.

The Tribunal awarded the maximum 50 per cent award on the cost of the vehicle, the difference in rent, and the late attendant care payment.

The Tribunal also deemed the rental difference incurred for a specific period pursuant to s. 3(8) of the Schedule.

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

The matter was scheduled for a videoconference hearing, but the applicant failed to attend without providing a reason.

This was the third hearing the applicant had missed.

The adjudicator proceeded in the applicant's absence pursuant to section 7(1) of the Statutory Powers and Procedures Act.

As the applicant presented no evidence to support her claim, the application was dismissed.

The respondent's request for costs was also denied, as the adjudicator found the absenteeism did not merit a costs award.

The applicant sought a non-earner benefit (NEB) and payment for multiple treatment plans following a 2017 motor vehicle accident.

The Licence Appeal Tribunal found that the applicant's entitlement to a NEB was not triggered because he failed to submit a completed disability certificate within the required 104-week timeframe and did not provide a reasonable explanation for the delay.

The Tribunal also dismissed the claims for the treatment plans, preferring the respondent's insurer examination reports which concluded the requested psychological, chronic pain, physiotherapy, and occupational therapy services were not reasonable and necessary.

Claims for an award and interest were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing his injuries warranted removal from the Minor Injury Guideline (MIG) due to pre-existing arthritis, cervical spine degeneration, and psychological impairments.

The Tribunal found the applicant failed to provide compelling evidence of a pre-existing condition documented prior to the accident that would prevent maximal recovery within the MIG.

The Tribunal also found insufficient evidence of a psychological impairment.

As the MIG limit was exhausted, the disputed treatment plans were not payable.

The applicant's claim for a non-earner benefit was dismissed because he had resumed his normal activities of daily living and did not suffer a complete inability to carry on a normal life.

The application was dismissed.

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

The respondent denied several treatment plans 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 she should be removed from the MIG due to pre-existing psoriatic rheumatoid arthritis, psychological conditions, and chronic pain.

The Tribunal found the applicant failed to provide compelling evidence that her pre-existing conditions prevented her maximal recovery under the MIG, noting a lack of concurrent medical reporting of the accident.

The Tribunal also found insufficient evidence of accident-related functional impairment to support a chronic pain diagnosis.

As the MIG limit was exhausted, the disputed treatment plans were not payable, and the application was dismissed.

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

The respondent initially denied claims based on the Minor Injury Guideline (MIG) and a lack of supporting medical documentation, but later removed the applicant from the MIG and approved outstanding treatment plans prior to a case conference.

The only remaining issues were the applicant's entitlement to interest and a special award under s. 10 of Regulation 664 for unreasonable delay.

The Tribunal found that the applicant failed to prove the respondent's conduct was unreasonable, noting that the applicant's noncompliance with s. 33 requests for legible medical records frustrated the adjustment process.

The application for an award and interest was dismissed.

The applicant sought payment for four treatment plans for chiropractic services and other goods following a motor vehicle accident.

The respondent denied the plans based on insurer's examinations concluding the applicant had reached maximum medical recovery.

The Tribunal found that one treatment plan for $1,977.05 was reasonable and necessary to determine if maximum medical recovery had been reached, noting the insurer's assessors failed to review the family physician's clinical notes.

The remaining three treatment plans were dismissed due to a lack of contemporaneous complaints of pain or insufficient evidence justifying their necessity.