Monica Purdy

The applicant was injured in a motor vehicle accident and sought various medical benefits, including physiotherapy, occupational therapy, and psychological services, which the respondent insurer denied.

The Licence Appeal Tribunal found that the applicant's compression fracture was caused by the accident and that the disputed treatment plans were reasonable and necessary.

The Tribunal also found that the respondent unreasonably withheld benefits, particularly where its own assessors had recommended treatment, and ordered a 50% special award under s. 10 of Regulation 664 along with interest on overdue payments.

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits for chiropractic services.

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

The applicant argued that her chronic pain condition took her outside the MIG and that the respondent had conceded the MIG limits by previously paying benefits in excess of the cap due to an administrative error.

The Tribunal found that the administrative error did not remove the applicant from the MIG.

Furthermore, the Tribunal rejected the applicant's chronic pain evidence as unpersuasive due to unexplained gaps in treatment and a lack of supporting medical documentation.

The Tribunal concluded that the applicant's injuries were predominantly minor, dismissed the claim for benefits, and denied the request for an award for unreasonable delay.

The applicant was injured in a motor vehicle accident and subsequently suffered two workplace accidents.

He sought medical benefits for orthopaedic, chronic pain, and neurological assessments, as well as psychological treatment, arguing his injuries fell outside the Minor Injury Guideline.

The Tribunal found that the injuries from the motor vehicle accident were predominantly minor soft tissue injuries.

Furthermore, the Tribunal determined that the applicant's chronic pain and psychological impairments were caused by the subsequent workplace accidents, not the motor vehicle accident.

The application for benefits was dismissed.

The applicant, who sustained a catastrophic impairment in a motor vehicle accident, sought attendant care benefits at the statutory maximum of $6,000 per month, despite only incurring a fraction of that amount.

The Tribunal held that under the Statutory Accident Benefits Schedule, the insurer is only liable to pay for attendant care expenses actually incurred, not the maximum assessed amount.

The Tribunal also dismissed the applicant's claim for a second $2,200 neuropsychological treatment plan, finding it was part of a single assessment subject to the $2,000 statutory cap.

The applicant was injured in a motor vehicle accident and applied for non-earner benefits.

The respondent denied the claim and later argued the applicant was statute-barred from appealing due to the two-year limitation period, and that the applicant could not advance the claim because a supportive disability certificate was not submitted until September 2016.

The Tribunal found the appeal was filed within the limitation period, which began running five days after the denial letter was mailed.

The Tribunal also held the applicant could advance his claim for non-earner benefits based on an October 2014 election of benefits and an incomplete disability certificate, as the respondent had sufficient information to know the applicant was claiming the benefit.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs) and medical benefits for physiotherapy and chiropractic treatment.

The insurer denied the claims.

The Tribunal found that the applicant was not entitled to IRBs for the initial period due to her failure to provide requested financial information on time.

However, the Tribunal concluded that the applicant suffered a substantial inability to perform the essential tasks of her pre-accident employment as a kitchen helper due to her physical and deteriorating psychological impairments, entitling her to IRBs for the subsequent periods claimed.

The Tribunal denied the medical benefits, finding that the applicant's physical injuries had largely resolved and the disputed treatment plans were not reasonable and necessary.

The applicant filed an application for statutory accident benefits following a motor vehicle accident.

The applicant failed to attend two scheduled case conferences and did not submit a required case conference summary.

The Tribunal found that the applicant had been properly served with notices of the case conferences.

Pursuant to Rule 3 of the Licence Appeal Tribunal Rules of Practice and Procedure, the Tribunal deemed the application abandoned and dismissed it without a hearing.