Samia Makhamra

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

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

The Tribunal found that the applicant's injuries, which included a compression fracture at L1 and a psychological adjustment disorder, were not predominantly minor and therefore did not fall within the MIG.

The Tribunal ordered the respondent to pay the disputed medical benefits for chiropractic services, a psychological assessment, and a MIG discharge report, along with interest on overdue payments.

The applicant sought medical and rehabilitation benefits following a motor vehicle accident.

The respondent insurer raised a preliminary issue, arguing the applicant was precluded from proceeding with her application under s. 55(2) of the Statutory Accident Benefits Schedule because she failed to attend requested s. 44 insurer's examinations.

The Tribunal found the applicant was not precluded from proceeding with her physical rehabilitation claims because the insurer ultimately conducted a paper review examination that did not require her attendance.

However, the Tribunal found the applicant was precluded from proceeding with her psychological assessment claim because she failed to attend the scheduled in-person examinations and the insurer's notices of examination were sufficient and compliant with s. 44(5).

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

At a case conference, it became clear the application was premature as there were no denials from the respondent, leading the applicant to withdraw the application.

The respondent subsequently brought a motion for costs, arguing the applicant's conduct was frivolous, vexatious, and in bad faith.

The Tribunal dismissed the motion, finding that while the application lacked necessary information and the applicant briefly used profane language out of frustration, his conduct did not rise to the level of being unreasonable, frivolous, vexatious, or in bad faith.

The applicant brought a motion for an order requiring non-party assessors and their assessment facility to produce their complete files, including draft reports, clinical notes, and correspondence.

The applicant sought these documents to clarify changes made between draft and final reports regarding a catastrophic impairment determination.

As the respondent and the assessment facility did not oppose the request, the Tribunal ordered the production of the requested documents.

The applicant tripped and fell headfirst into a parked vehicle while running down a street, sustaining catastrophic injuries.

The respondent denied statutory accident benefits, arguing the incident was not an 'accident' under the Schedule.

The Tribunal found that the applicant did make contact with the parked vehicle, that parking is an ordinary use of a vehicle satisfying the purpose test, and that the impact with the vehicle directly caused the injuries, satisfying the causation test.

The Tribunal concluded the applicant was involved in an 'accident' as defined in the Schedule.

The applicant sought payment for various medical and assessment benefits following a motor vehicle accident.

The respondent insurer denied the benefits on the basis that the applicant's injuries were predominantly minor and subject to the $3,500 limit under the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's injuries were soft tissue in nature and fell within the MIG.

The Tribunal preferred the evidence of the insurer's examiners over the applicant's assessors, noting the former reviewed comprehensive medical records.

Furthermore, the applicant failed to provide compelling evidence of a pre-existing medical condition that would warrant an exception to the MIG cap.

The application was dismissed.

The applicant sought statutory accident benefits for medical and rehabilitation treatments following a motor vehicle accident.

The respondent insurer denied the treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The Tribunal found that the applicant's injuries were predominantly minor and that she failed to provide compelling evidence of a pre-existing medical condition that would entitle her to treatment beyond the MIG cap.

The application for benefits and interest was dismissed.