Danielle Wilkinson

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

The respondent insurer denied the treatment plans on the basis that the injuries fell within the Minor Injury Guideline and required the applicant to attend insurer's examinations (IEs).

The applicant failed to attend multiple scheduled IEs over a nine-month period, later claiming the notices were non-compliant with the Schedule.

The Tribunal found that the respondent's notices were sufficient and compliant, as they clearly stated the medical and other reasons for the IEs.

Consequently, the applicant was found to be in non-compliance with section 44 of the Schedule.

Pursuant to section 55, the application was dismissed and the Tribunal file closed.

The respondent's request for costs was denied.

The applicant sought an income replacement benefit and the cost of a psychological assessment following a motor vehicle accident.

The adjudicator found that the applicant failed to prove a substantial inability to perform the essential tasks of his pre-accident employment as an articling student, noting contradictions in his evidence and a lack of supporting medical documentation.

The adjudicator also denied the psychological assessment, accepting the respondent's expert evidence that the applicant did not suffer from a clinically significant, accident-related psychological impairment.

Both parties' requests for costs were dismissed.

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRB) until returning to work.

Over nine years later, the applicant sought reinstatement of the IRB.

The insurer argued the claim was statute-barred, relying on a 2006 Explanation of Benefits (EOB) as a denial, and alternatively argued the applicant failed to apply within 104 weeks.

The Tribunal found the EOB was a statement of statutory entitlement under the Pre-Approved Framework, not a clear and unequivocal denial.

The Tribunal also found no requirement to apply within 104 weeks, and regardless, the initial claim was made within that period.

The preliminary motion to dismiss was denied.

The applicant applied for arbitration regarding statutory accident benefits following a motor vehicle accident.

After her counsel was removed from the record due to an inability to contact her, the applicant failed to attend the scheduled arbitration hearing despite receiving notice.

The insurer brought a motion to dismiss the application.

The arbitrator granted the motion, finding that the applicant failed to meet her onus of proof by not attending the hearing.

The application for arbitration was dismissed with no costs awarded.