Caleb Medeiros

The applicant, an international student who was struck by a vehicle while cycling, sought income replacement benefits, medical benefits, and lost educational expenses from the respondent insurer.

The adjudicator dismissed the applicant's claims, finding that he failed to establish his pre-accident employment and income, and did not provide compelling medical evidence of disability.

The claims for medical benefits were dismissed because the applicant had exhausted the $65,000 non-catastrophic funding limit.

Furthermore, the adjudicator ordered the applicant to repay $10,513.56 in overpaid income replacement benefits, concluding that the applicant committed wilful misrepresentation by failing to disclose his return to work and post-accident earnings.

The applicant was injured in a motor vehicle accident and sought payment for the unapproved balances of three treatment plans for psychological services and catastrophic impairment assessments.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the proposed hourly rate of $224.42 for psychological services was reasonable and necessary, as it exceeded the maximum rate in the Professional Services Guidelines.

The Tribunal also found the applicant failed to justify the cost of clinical file review assessments, which appeared to duplicate approved in-person assessments.

Claims for interest and an award were consequently dismissed.