Robert Markovits

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

The respondent insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit was exhausted.

The Licence Appeal Tribunal found that the applicant had a pre-existing elbow condition that was exacerbated by the accident, preventing him from achieving maximal recovery within the MIG limits.

The Tribunal also found the disputed treatment plans for chiropractic, physiotherapy, and a psychological assessment to be reasonable and necessary, ordering the insurer to pay the benefits with interest.

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

The adjudicator found that the applicant's psychological impairments (adjustment disorder and specific phobia) removed him from the MIG.

The adjudicator ordered the respondent to pay for several chiropractic and physiotherapy treatment plans, finding them reasonable and necessary, and noting the insurer's failure to comply with the 10-day notice requirement under s. 38(8) of the Schedule for some plans.

Claims for a driving re-integration assessment and a chronic pain assessment were dismissed as not reasonable and necessary.

The applicant was awarded interest on overdue payments, but both parties' claims for costs under Rule 19.1 were dismissed.

The respondent brought a motion to exclude the applicant's reply submissions, which were filed four days after the deadline set at the case conference.

The adjudicator dismissed the motion, finding that the respondent suffered no prejudice from the delay, no new issues were raised in the reply, and all submissions were received prior to the scheduled written hearing date.

The respondent insurer brought a motion seeking the production of 36 documents, including medical and employment records, relying on a case conference order that required the applicant to produce 'all relevant documents as necessary'.

The adjudicator dismissed the motion, finding that the phrase in the order referred only to specific hospital and ambulance reports previously discussed.

The adjudicator noted that the respondent failed to explain the relevance of the requested documents and that it was not open to the respondent to seek medical records to justify previously denied benefits.

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

The applicant failed to attend the initial case conference and was warned that failure to attend the reconvened case conference would result in the appeal being dismissed as abandoned.

Despite attempts by counsel to contact the applicant, he failed to attend the second case conference.

The respondent brought a motion to dismiss the appeal.

The Tribunal found no reasonable explanation for the applicant's repeated absence and dismissed the appeal as abandoned pursuant to Rule 3.4 of the Licence Appeal Tribunal Rules of Practice and Procedure.