Jonathon Dick

The applicant, a minor injured in a motor vehicle accident, sought payment for two treatment plans for physical medical and oculo-visual services.

The respondent insurer initially provided non-compliant notices of denial under s. 38(8) of the Statutory Accident Benefits Schedule but later provided compliant notices following insurer's examinations.

The Tribunal found that while the initial non-compliance triggered the 'shall pay' provision of s. 38(11)2, the applicant had not incurred any expenses during the relevant period, relying on the Divisional Court's decision in Catic.

The applicant also failed to provide evidence that the treatment plans were reasonable and necessary.

The application for benefits, interest, and a special award was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy and psychological services.

The respondent denied the treatment plans, and the applicant applied to the Licence Appeal Tribunal.

The Tribunal found that the applicant failed to prove the physiotherapy plan was reasonable and necessary, as the medical evidence did not corroborate the need for the proposed treatments and the applicant had reported physiotherapy made her worse.

However, the Tribunal partially approved the psychological treatment plans, finding the requested time for mental health testing and completing the OCF-18 form to be reasonable, while reducing the time claimed for session preparation and notetaking.

The applicant was awarded $274.81 for psychological services plus interest.

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

The respondent denied the benefits, arguing the treatments were not reasonable and necessary.

The Tribunal found that while the accident caused the applicant's injuries and ongoing pain, the proposed treatment plans were not reasonable and necessary.

Medical evidence indicated that the applicant had achieved his goals of increased range of motion and strength, and that previous chiropractic treatments provided only temporary relief.

The application was dismissed.