Lisa Holland

The applicant sought income replacement benefits following a motor vehicle accident.

In a previous Tribunal decision, the applicant was barred from proceeding with his claim because he failed to attend a properly scheduled insurer's examination under s. 44 of the Schedule.

The applicant subsequently filed a new application raising the same substantive issues.

The Tribunal found that the doctrine of res judicata applied, as the previous decision was final and disposed of the substantive issue.

The Tribunal declined to waive res judicata, finding no fresh evidence or fairness reasons to do so, and dismissed the application.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, including attendant care benefits and funding for a multidisciplinary catastrophic impairment assessment.

The respondent insurer denied the benefits.

The Tribunal found that the applicant failed to prove the attendant care benefits were reasonable and necessary, as insurer's examinations indicated she had returned to her pre-accident functional abilities.

The Tribunal also denied the catastrophic impairment assessment treatment plan, finding insufficient medical evidence to support that it was reasonably possible the applicant sustained a catastrophic impairment.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought accident benefits, which the respondent insurer denied on the basis that the injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG due to a pre-existing major depressive disorder and accident-related psychological impairments.

The Tribunal found insufficient medical evidence that the pre-existing condition precluded recovery within the MIG, noting the applicant's self-reports to the assessor were inconsistent with pre-accident clinical records.

The Tribunal concluded the injuries were predominantly minor, dismissing the claims for chiropractic services, a psychological assessment, and interest.

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

The respondent denied benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG due to chronic pain and psychological impairments.

The Tribunal found that the applicant failed to provide sufficient medical evidence to establish chronic pain with functional impairments or accident-related psychological impairments.

As the MIG limits were exhausted, the claim for a physiotherapy treatment plan and interest was dismissed.

The applicant sought a non-earner benefit (NEB) following a motor vehicle accident.

The Tribunal found that the applicant failed to establish a complete inability to carry on a normal life, noting he returned to work shortly after the accident.

The applicant also argued the respondent failed to comply with the notice provisions under sections 35 and 36 of the Schedule.

The Tribunal held that the respondent's denial of the NEB on the basis that the applicant qualified for an income replacement benefit was valid and compliant with section 36(4).

The application was dismissed, and claims for interest and an award were denied.

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

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

The applicant applied to the Licence Appeal Tribunal, arguing he should be removed from the MIG due to a psychological impairment.

The Tribunal found the applicant failed to prove a psychological condition warranting removal, noting he returned to work shortly after the accident and his family physician's records contained no psychological complaints.

The application for physiotherapy, a psychological assessment, and interest was dismissed.

The applicant sought a non-earner benefit and a determination that their injuries fell outside the Minor Injury Guideline following a motor vehicle accident.

The Tribunal found that the applicant was statute-barred from pursuing the non-earner benefit because they failed to dispute the insurer's clear and unequivocal denial within the two-year limitation period.

The Tribunal also held that it lacked jurisdiction to make a standalone determination regarding the Minor Injury Guideline in the absence of an underlying dispute for medical or rehabilitation benefits.

The application was dismissed.

The applicant sought outstanding balances for attendant care benefits following a motor vehicle accident.

The respondent had partially approved the invoices using a ratio method because the invoices lacked the required particulars to substantiate the services provided.

The Tribunal found that the applicant failed to demonstrate she incurred the full balance of the invoices and upheld the respondent's use of the ratio method.

The application for outstanding benefits, interest, and an award was dismissed.

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

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

The applicant argued she should be removed from the MIG due to chronic pain.

The Tribunal found the applicant failed to demonstrate on a balance of probabilities that she suffered from accident-related chronic pain with functional impairment, noting her pre-existing conditions and lack of functional impairment.

The application was dismissed, and the applicant was found not entitled to the disputed treatment plans or interest.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, attendant care benefits, and numerous treatment plans for psychological, cognitive, and occupational therapy assessments and services.

The Tribunal found the claim for the non-earner benefit was statute-barred because the applicant failed to dispute the insurer's clear and unequivocal denial within the two-year limitation period.

The Tribunal dismissed the claims for the treatment plans and attendant care benefits, finding the applicant failed to prove they were reasonable and necessary for accident-related injuries, largely due to significant pre-existing psychological conditions and a lack of supporting medical evidence.

Claims for interest and an award for unreasonable delay were also dismissed.

The applicant sought income replacement benefits (IRBs) and payment for various physiotherapy and psychological treatment plans following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application in its entirety.

The adjudicator found the applicant failed to prove a substantial inability to perform his pre-accident employment tasks or a complete inability to engage in suitable employment post-104 weeks, noting he had returned to work.

The treatment plans were deemed not reasonable and necessary, as medical evidence indicated the applicant's psychological issues stemmed from pre-existing conditions and subsequent accidents, and he had reached maximum medical recovery for his soft tissue injuries.

Claims for an award and interest were consequently dismissed.

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

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

The Tribunal found the applicant failed to prove on a balance of probabilities that he suffered from chronic pain with functional impairment or a psychological condition warranting removal from the MIG.

Furthermore, the Tribunal held that the respondent's denial notices complied with s. 38(8) of the Schedule by adequately identifying the applicant's condition as minor and requesting necessary medical information.

The application was dismissed.

The applicant sought accident benefits following a motor vehicle accident, disputing the respondent's determination that her injuries fell within the Minor Injury Guideline (MIG).

The applicant also claimed entitlement to an income replacement benefit (IRB) and various treatment plans.

The Tribunal found that the applicant failed to provide medical evidence warranting removal from the MIG, relying on insurer examination reports confirming only soft tissue injuries.

The IRB claim was dismissed as the applicant had returned to modified work and continued receiving sick pay, failing to prove a substantial inability to perform essential tasks or provide updated income documentation.

The Tribunal also upheld the respondent's denials of the treatment plans as procedurally valid under s. 38(8) of the Schedule.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs), treatment plans for physiotherapy and psychological assessments, catastrophic assessment costs, and visitor expenses.

The Licence Appeal Tribunal dismissed the application in its entirety.

The adjudicator found that the applicant failed to meet her burden of proof for all claims, as she did not provide sufficient medical or documentary evidence to establish that she suffered a substantial or complete inability to work, or that the disputed treatment plans and expenses were reasonable and necessary as a result of the accident.

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

In a previous Licence Appeal Tribunal decision, it was determined that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant filed a second application seeking removal from the MIG and payment for new treatment plans.

The respondent raised the preliminary issue of res judicata.

The Tribunal found that the three preconditions for issue estoppel were met and that there was no fresh, new evidence to warrant waiving the doctrine.

The Tribunal dismissed the application as barred by res judicata and declined to award costs to the respondent.

The applicant sought statutory accident benefits for a catastrophic impairment following a motor vehicle accident.

The Licence Appeal Tribunal had previously determined in a 2024 decision that the applicant did not sustain a catastrophic impairment.

The applicant filed a second application based on new medical reports.

The respondent raised the preliminary issue of res judicata.

The Tribunal found that the three preconditions for res judicata were met.

Furthermore, the Tribunal declined to waive the doctrine, finding that the new medical reports did not constitute fresh evidence that would conclusively impeach the original results, as they relied on the applicant's inaccurate self-reporting of her pre-accident condition.

The application was dismissed.

The applicant sought statutory accident benefits for medical services and other goods and services following a motor vehicle accident.

The respondent denied the benefits and the matter proceeded to a written hearing.

The adjudicator declined to allow the respondent to raise a new preliminary issue regarding the applicant's failure to submit an application for benefits on time, finding it procedurally unfair.

The adjudicator also excluded late-filed medical records and a chiropractor's letter submitted by the applicant, as they were produced after the disclosure deadline without explanation, prejudicing the respondent.

Ultimately, the application was dismissed because the applicant failed to provide copies of the disputed treatment plans or make specific submissions to establish that the proposed services were reasonable and necessary.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found her accident-related injuries fell within the Minor Injury Guideline (MIG).

The applicant argued the Tribunal breached procedural fairness and made errors of law and fact by failing to properly consider the medical evidence of her neurologist and chiropractor regarding her chronic pain.

The Adjudicator dismissed the request, finding that the original Tribunal properly weighed the evidence, provided adequate reasons for rejecting the uncontradicted medical reports, and made no errors of law or fact in its application of the MIG.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing her injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain.

The Licence Appeal Tribunal found the applicant failed to meet her burden of proof, noting the medical evidence conflated injuries from the subject accident with a subsequent accident and did not engage with the AMA Guides criteria for chronic pain.

As the applicant remained subject to the MIG and the monetary limits were exhausted, the disputed treatment plans for neurological and chronic pain assessments were denied.

Claims for interest and a section 10 award were also dismissed.

The applicant sought entitlement to a non-earner benefit, various treatment plans for physiotherapy and psychological services, an attendant care assessment, and an award under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The Tribunal found the applicant failed to establish a complete inability to carry on a normal life, as there was insufficient evidence comparing his pre- and post-accident activities.

The Tribunal also dismissed the claims for the treatment plans, preferring the respondent's insurer examination reports which indicated the applicant had returned to his activities of daily living and sustained only minor injuries.

The application was dismissed in its entirety.