Michael Beauchesne

The respondent insurer requested a reconsideration of a Tribunal decision that awarded the applicant a non-earner benefit (NEB) with interest.

The insurer argued the Tribunal erred in law by failing to consider the applicant's non-compliance with a section 33 request for medical documents.

The Adjudicator agreed, finding that the Tribunal failed to apply its own finding that the insurer had cured a deficient section 33 request.

Because the applicant did not comply with the valid section 33 request, the insurer was not liable to pay the NEB during the period of non-compliance.

The reconsideration was granted in part, and the decision was varied to find the applicant not entitled to the NEB or interest.

The applicant sought statutory accident benefits following a motor vehicle accident, including attendant care benefits and various treatment plans.

The respondent denied the benefits, arguing that an intervening accident broke the chain of causation and relying on its own independent medical examinations.

The Tribunal found that the subject accident was a necessary cause of the applicant's physical injuries, but not her psychological complaints.

The Tribunal awarded partial attendant care benefits for meal preparation and laundry assistance, and approved several treatment plans including occupational therapy, a cognitive assessment, and vestibular physiotherapy.

The Tribunal also ordered a 10 per cent special award against the respondent for unreasonably maintaining the applicant in the Minor Injury Guideline despite knowing she had sustained a concussion.

The appellant appealed the 45-day impoundment of her motor vehicle under the Highway Traffic Act, arguing that the impoundment caused exceptional hardship.

The vehicle was impounded after her boyfriend was caught driving it with a suspended licence.

The Licence Appeal Tribunal dismissed the appeal, finding that the appellant failed to demonstrate that there were no reasonable alternatives to the impounded vehicle, as she had been using taxis and public transit to commute to work and fulfill her needs.

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

The applicant requested an adjournment of the written hearing, or alternatively, leave to withdraw the application, citing an inability to retain new counsel after his previous representative withdrew.

The adjudicator found the adjournment request was improperly filed under LAT Rule 16.1 and would have been denied regardless due to the procedural history, which included two prior adjournments for the same reason.

The adjudicator accepted the applicant's alternative request to withdraw the application and ordered the Tribunal's file closed.

The appellants appealed a Notice of Proposal by the Registrar to suspend their registrations as a broker and brokerage under the Trust in Real Estate Services Act, 2002.

The appellants failed to attend the hearing.

The Tribunal found that the appellants repeatedly failed to produce required trust account reconciliation statements and bank records despite multiple requests from the regulator.

The Tribunal concluded that the appellants' past conduct afforded reasonable grounds for belief that they would not carry on business in accordance with the law and with integrity and honesty.

The appeal was dismissed and the Registrar was directed to carry out the proposal to suspend the registrations.

The applicant sought statutory accident benefits following a 2018 motor vehicle accident.

The respondent denied ongoing income replacement benefits (IRB) and several treatment plans (OCF-18s).

As a preliminary issue, the respondent argued the IRB and neurological assessment claims were statute-barred by the two-year limitation period.

The Tribunal found the IRB denial notice was clear and unequivocal, triggering the limitation period, but granted an extension under section 7 of the LAT Act based on the Manuel factors.

On the substantive issues, the Tribunal held the respondent's IRB denial notice failed to provide medical reasons as required by section 37 of the Schedule, entitling the applicant to the IRB from the date of stoppage.

However, the applicant failed to prove the disputed OCF-18s were reasonable and necessary.

The claim for an award under Regulation 664 was dismissed.

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

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

The applicant sought removal from the MIG based on a pre-existing condition and chronic pain.

The Tribunal found the applicant failed to prove her injuries fell outside the MIG, as she did not provide compelling evidence that her pre-existing conditions prevented maximal recovery within the MIG, nor did she establish chronic pain with functional impairment.

As the MIG limit was exhausted, the treatment plans were denied.

Claims for interest and a special award were also dismissed.

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

The adjudicator found the applicant was barred from pursuing a non-earner benefit because he failed to prove he submitted a disability certificate (OCF-3) within the limitation period.

The applicant was also barred from pursuing three treatment plans because he failed to attend reasonably necessary insurer's examinations without a reasonable explanation.

On the substantive issues, the adjudicator held the applicant's injuries fell within the Minor Injury Guideline (MIG), denying a proposed physiotherapy treatment plan for lack of reasonableness and necessity.

Claims for an award and interest were also dismissed.

The applicant sought entitlement to a non-earner benefit and two treatment plans for medical and occupational therapy services following a motor vehicle accident.

The Tribunal found that while the applicant sustained a concussion in the accident, she failed to demonstrate a complete inability to carry on a normal life, as evidence showed she continued her university studies with high grades and accommodations.

The claims for the treatment plans were dismissed because the applicant failed to produce the OCF-18s in evidence or make submissions on their specific goals and modalities, making it impossible to assess their reasonableness and necessity.

The application was dismissed in its entirety.

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

The respondent denied benefits and requested the applicant attend Insurer's Examinations (IEs).

The applicant failed to attend multiple scheduled IEs, citing unavailability and transportation issues.

The Tribunal found the applicant failed to provide a reasonable explanation for her non-attendance.

Consequently, the applicant is barred under section 55(1) of the Schedule from proceeding to a hearing, and the application was dismissed.

The applicant sought an income replacement benefit (IRB) and an award for unreasonable delay following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to establish the essential tasks of his pre-accident employment and did not prove a substantial inability to perform those tasks within the first 104 weeks.

Furthermore, the applicant failed to demonstrate a complete inability to engage in any suitable employment after 104 weeks.

The claim for an award was also dismissed as the applicant provided no evidence or arguments to support it.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming her pre-existing chronic mechanical low back pain warranted removal from the Minor Injury Guideline (MIG) and that she was entitled to a non-earner benefit (NEB).

The Tribunal found the applicant failed to provide compelling medical evidence that her pre-existing condition precluded maximal recovery within the MIG.

Furthermore, the Tribunal held the applicant did not suffer a complete inability to carry on a normal life, relying on functional assessments showing she retained significant independence and mobility.

The application was dismissed, and the applicant remained subject to the MIG limits.

The applicant sought accident benefits for a psychological assessment and psychological services following a motor vehicle accident.

The respondent denied the treatment plans and raised a preliminary issue regarding the two-year limitation period.

The Tribunal found the application was commenced within the limitation period, factoring in mailing delivery standards.

On the substantive issues, the Tribunal dismissed the claims, finding the applicant failed to demonstrate the treatment plans were reasonable and necessary.

The Tribunal noted a lack of contemporaneous evidence of psychological complaints and found the applicant's pre-accident medical history contradicted her reports to the assessors.

The applicant sought entitlement to a treatment plan for psychiatric services following a 2017 motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the claim was barred by the 260-week limitation period under section 20(1) of the Schedule, as the treatment plan was submitted more than five years after the accident.

The Tribunal further held that even if the limitation period did not apply, the applicant failed to demonstrate that the proposed psychiatric treatment was reasonable and necessary.

Claims for an award and interest were also dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found she did not sustain a catastrophic impairment and was not entitled to attendant care benefits.

The applicant argued the Tribunal erred by applying the 'but-for' test instead of the 'material contribution' test, misinterpreting the Schedule, failing to find an exacerbation of her pre-existing conditions, and not applying an adverse inference for the respondent's alleged spoliation of expert raw data.

The Tribunal dismissed the request, finding that the applicant was attempting to advance new arguments not raised at the initial hearing and re-litigate findings of fact and weight of evidence.

The Tribunal confirmed no errors of law or fact were made that would have changed the outcome.

The applicant sought statutory accident benefits following a 2013 motor vehicle accident, claiming entitlement to attendant care benefits, incurred attendant care expenses, various medical and rehabilitation benefits, and an award for unreasonable delay.

The Licence Appeal Tribunal dismissed the application in its entirety.

The Tribunal found that the applicant failed to meet her evidentiary burden, largely due to significant discrepancies between her written submissions and her hearing brief, which omitted crucial evidence.

The applicant failed to prove that the proposed attendant care and medical benefits were reasonable and necessary, or that the claimed expenses were incurred.

The applicant sought various statutory accident benefits, including attendant care benefits, medical benefits, and assessments, following a 2013 motor vehicle accident.

The Licence Appeal Tribunal held a written hearing to resolve the disputes.

The Tribunal dismissed the application in its entirety, finding that the applicant's case was significantly hampered by discrepancies between her written submissions and her hearing brief, including missing evidence and failure to pinpoint relevant documents.

The applicant failed to meet her onus to prove entitlement to attendant care benefits, incurred expenses, or the reasonableness and necessity of the proposed treatment and assessment plans.

Claims for interest and a special award were also dismissed.

The applicant sought income replacement benefits (IRBs) and a special award following a motor vehicle accident.

The respondent brought a motion to strike new evidence introduced in the applicant's reply submissions, which the Tribunal granted, finding the late introduction prejudicial.

On the merits, the Tribunal dismissed the application for IRBs, finding the applicant failed to prove she was employed at the time of the accident or establish the essential tasks of her alleged employment.

The Tribunal also found insufficient evidence to support a complete inability to work post-104 weeks.

The claims for interest and a special award were dismissed.

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

The applicant claimed entitlement to a non-earner benefit, various treatment plans, and removal from the MIG due to pre-existing conditions, psychological impairments, and chronic pain syndrome.

The Licence Appeal Tribunal found that the applicant failed to establish that her pre-existing conditions precluded recovery within the MIG, nor did she prove accident-related psychological impairments or chronic pain syndrome.

The Tribunal also dismissed the claim for a non-earner benefit, finding insufficient evidence of a complete inability to carry on a normal life.

As the applicant remained in the MIG and the limits were exhausted, the disputed treatment plans were denied.

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

The applicant relied exclusively on procedural arguments, claiming the respondent failed to comply with notice provisions under the Schedule.

The Tribunal found the applicant remained in the Minor Injury Guideline and was not entitled to the disputed treatment plan, as he failed to lead substantive evidence and the respondent's notices regarding the treatment plan were compliant.

However, the Tribunal found the respondent's notice requiring an insurer's examination for the non-earner benefit was deficient under section 44(5) of the Schedule.

Consequently, the respondent was ordered to pay the non-earner benefit pursuant to section 36(6).

The claim for an award was dismissed.