Danielle Ralph

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

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

The Licence Appeal Tribunal found that the applicant failed to prove his physical or psychological injuries fell outside the MIG definition.

As the $3,500 limit for minor injuries had been exhausted, the disputed treatment plans were denied.

Claims for an award for unreasonable delay and interest were also dismissed.

The applicant sought medical and rehabilitation benefits following a motor vehicle accident, including a neurological assessment, physiotherapy, a dog, medical cannabis, and a dental night guard.

The respondent denied the benefits.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to meet her burden of proving that the claimed expenses were reasonable and necessary as a result of accident-related injuries, noting her pre-existing chronic pain and fibromyalgia.

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

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 sustained a concussion, which falls outside the Schedule's definition of a minor injury, thereby removing him from the MIG.

The Tribunal further held that the disputed $3,297.08 physiotherapy treatment plan was reasonable and necessary to treat the applicant's accident-related injuries, which had been exacerbated by a subsequent accident.

The treatment plan was ordered payable with interest.

The insurer requested a reconsideration of a preliminary issue decision which found that section 56 of the Statutory Accident Benefits Schedule did not bar the applicant's claim for a non-earner benefit.

The Tribunal dismissed the request, finding that under Rule 18 of the Common Rules of Practice and Procedure, it can only reconsider decisions that finally dispose of an appeal.

Because the preliminary issue decision was interlocutory and did not deprive the insurer of a substantive right determinative of the entire application, it was not subject to reconsideration.

The applicant's request for costs was also dismissed.

The applicant sought a Non-Earner Benefit following a motor vehicle accident, claiming physical and psychological impairments, including chronic pain, alcohol dependence, and personality changes, completely prevented her from carrying on her pre-accident life of renovating houses.

The Tribunal found that the applicant remained engaged in her renovation projects post-accident and that her psychological issues, including Alcohol Use Disorder and Cluster B personality traits, pre-existed the accident.

Applying the 'but for' test, the Tribunal concluded the accident was not a necessary cause of her ongoing impairments and she did not suffer a complete inability to carry on a normal life.

The application was dismissed.

The applicant was involved in a motor vehicle accident and sought non-earner benefits.

The respondent raised a preliminary issue, arguing that the applicant was barred from proceeding with her claim under section 56 of the Statutory Accident Benefits Schedule because she failed to establish eligibility within the prescribed time limit.

The Tribunal found that the respondent had never issued a clear and unequivocal denial of a specific claim for the benefit, as no claim existed at the time of the purported denials.

Therefore, the limitation period under section 56 was not triggered, and the applicant was not barred from proceeding with her application.