Andrez Belloso

The applicant sought entitlement to statutory accident benefits for chiropractic services and a chronic pain assessment following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant failed to prove the treatment plans were reasonable and necessary, relying on the respondent's section 44 assessors who concluded the applicant had reached maximal medical recovery for his minor injuries and that his heel pain was pre-existing.

The Tribunal also dismissed the claims for an award under section 10 of Regulation 664 and interest, as no benefits were overdue.

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

The respondent denied a treatment plan and the applicant applied to the Tribunal after the two-year limitation period expired.

The Tribunal found the respondent's denial was valid and triggered the limitation period.

The applicant failed to provide submissions to justify an extension of time under section 7 of the LAT Act.

As the treatment plan claim was statute-barred, the Tribunal ruled it could not hear the Minor Injury Guideline determination as a standalone issue.

The application was dismissed and costs were denied.

The applicant sought non-earner benefits following a motor vehicle accident, which were denied by the insurer.

The applicant filed an application with the Licence Appeal Tribunal 59 days after the expiry of the two-year limitation period, accounting for the COVID-19 suspension period.

The Tribunal applied the four-factor test under section 7 of the Licence Appeal Tribunal Act and found that the applicant had a bona fide intention to appeal, the delay was not significant, the respondent would not suffer prejudice, and there was some merit to the claim.

The Tribunal exercised its discretion to extend the limitation period and allowed the application to proceed.

The applicant sought statutory accident benefits for physiotherapy and a chronic pain assessment following a motor vehicle accident.

The insurer had removed the applicant from the Minor Injury Guideline due to a pre-existing psychological condition but denied the specific treatment plans.

The Licence Appeal Tribunal found that the applicant failed to prove the treatments were reasonable and necessary, preferring the evidence of the insurer's physiatrist over the applicant's psychologist regarding physical injuries.

The Tribunal also noted the applicant's high level of physical activity, such as skiing and golfing, which contradicted a chronic pain condition.

The application was dismissed.

The applicant sought reconsideration of a Licence Appeal Tribunal decision denying entitlement to two chiropractic treatment plans.

The applicant argued the Tribunal made significant errors of fact and sought to introduce new medical evidence.

The Vice-Chair dismissed the request, finding the proposed new evidence was either reasonably available prior to the hearing or would not have impacted the outcome.

The Vice-Chair further held that the Tribunal's weighing of the medical evidence, including assigning less weight to expert reports that lacked full medical history or relied on conjecture, was open to it on the evidence and did not constitute an error of fact.

The plaintiff brought a motion to transfer his action for long-term disability benefits to the Small Claims Court or, alternatively, to continue it under the Rule 76 Simplified Procedure.

The defendant opposed the motion, arguing prejudice due to the loss of its right to a jury trial and the advanced stage of the litigation.

The court dismissed the motion, finding that continuing under Rule 76 would improperly require striking a pre-2020 jury notice, which an Associate Justice lacks jurisdiction to do.

Furthermore, transferring to Small Claims Court at this late stage, after significant discovery and without compensating the defendant for costs thrown away, would be unfair and contrary to the interests of justice.

The applicant sought income replacement benefits (IRB) and medical/rehabilitation benefits following a motor vehicle accident.

The respondent denied the benefits and sought repayment of IRB previously paid, alleging the applicant had returned to work and wilfully misrepresented his employment status.

The Tribunal found that the applicant had returned to his pre-accident employment shortly after the accident and failed to prove a substantial inability to perform the essential tasks of his employment.

The Tribunal ordered the applicant to repay $1,619.99 in overpaid IRB due to his wilful misrepresentation.

The claims for psychological services and various medical assessments were dismissed as not reasonable and necessary.

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

The respondent denied the benefits, and the applicant applied to the Licence Appeal Tribunal.

The Tribunal found that the applicant failed to meet his onus of proving that the proposed chiropractic treatment plans were reasonable and necessary.

The applicant provided insufficient medical evidence to establish his accident-related physical injuries, particularly given a pre-existing back condition and a two-year gap in medical records following the accident.

The application was dismissed, and no interest or costs were awarded.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for chiropractic treatment and a psychological assessment.

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

The Licence Appeal Tribunal found that the applicant suffered a head injury and post-concussion syndrome, which exceed the definition of a minor injury, rendering the MIG inapplicable.

The Tribunal further held that the disputed treatment plans were reasonable and necessary to address the applicant's persistent cognitive challenges, ordering the respondent to pay the benefits with interest.