Dev Misir

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

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

The Tribunal found that the applicant failed to prove her injuries fell outside the MIG or that she had a pre-existing condition preventing maximal recovery within the MIG limit.

The Tribunal also found the proposed treatment plans were not reasonable and necessary.

The application was dismissed.

The insurer requested a reconsideration of a Licence Appeal Tribunal decision that awarded the applicant an income replacement benefit (IRB).

The insurer argued the Tribunal erred in finding the applicant had a reasonable explanation for failing to provide requested financial information under s. 33(1) of the Statutory Accident Benefits Schedule.

The Executive Chair agreed, finding no evidentiary basis for the applicant's explanation that his age and injuries delayed his compliance.

Consequently, under s. 33(6), the insurer was not liable to pay the IRB for the period of non-compliance.

The Tribunal's decision was varied to limit the IRB entitlement period.

The applicant sought statutory accident benefits, including physiotherapy, attendant care, and the cost of an assessment, following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the claims.

The claim for physiotherapy was denied because the applicant failed to provide the relevant treatment and assessment plan in evidence.

The claims for attendant care benefits and the assessment cost were dismissed because the applicant failed to comply with the procedural requirements of the Statutory Accident Benefits Schedule, specifically by incurring the expenses before submitting the required Form 1 and treatment plans to the insurer.

The applicant was injured in a motor vehicle accident and sought income replacement benefits, attendant care benefits, and the cost of an attendant care assessment.

The respondent denied the claims.

The Tribunal found that the applicant provided a reasonable explanation for his delay in providing financial documents.

The Tribunal held that the applicant was entitled to income replacement benefits because his injuries caused a substantial inability to perform the essential tasks of his import-export business.

However, the claims for attendant care benefits and the cost of examination were dismissed because the applicant failed to prove that his care provider suffered an economic loss or that the assessment was reasonable and necessary.

The Applicant sought to withdraw his Application for Arbitration regarding statutory accident benefits.

The Insurer consented to the withdrawal.

The Arbitrator exercised discretion under Rule 81.1(a) of the Dispute Resolution Practice Code to dispense with the requirement of filing a Statement of Service, and granted the request to withdraw the application pursuant to Rule 70.

The applicant sought to withdraw her application for arbitration regarding statutory accident benefits shortly before a scheduled pre-hearing conference.

The insurer opposed a withdrawal without conditions, requesting payment of its expenses, the $3,000 assessment fee, and an order precluding future applications on the same issues.

The arbitrator permitted the withdrawal without conditions, finding no evidence of abuse of process to justify ordering payment of the assessment fee or barring future applications.

However, the arbitrator ordered the applicant to pay the insurer's expenses fixed at $750 for the unnecessary costs incurred in preparing for the pre-hearing conference and responding to the withdrawal request.

Following the dismissal of the insured's application for statutory accident benefits, the insurer sought its expenses of the arbitration proceeding.

The insured's counsel did not file a response to the insurer's bill of expenses.

The arbitrator reviewed the claimed fees and disbursements, allowing the fees as claimed but disallowing a $1,112.00 disbursement for the attendance of a rheumatologist, finding the expert's opinion was neither necessary nor helpful.

The insurer was awarded total expenses of $8,795.97.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for caregiving and housekeeping expenses.

The insurer terminated these benefits based on in-home assessments and independent medical examinations indicating the applicant was not substantially disabled.

The applicant submitted invoices for services allegedly provided by her sister and a neighbour.

The arbitrator found the invoices to be unreliable and fabricated, noting they contradicted the applicant's own statements to assessors and the testimony of the service providers.

The application for benefits and a special award was dismissed, and the insurer was awarded its expenses of the arbitration proceeding.