Doha Tambal

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

The respondent denied various treatment plans.

The applicant filed an application with the Licence Appeal Tribunal.

The respondent raised a preliminary issue that the application was filed outside the two-year limitation period under s. 56 of the Schedule.

The Tribunal found that the respondent's denials were clear and unequivocal, and the application was filed more than two years after the denials.

The application was dismissed as statute-barred.

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

The respondent denied benefits beyond the $3,500 limit, arguing the injuries fell within the Minor Injury Guideline (MIG).

The applicant contended he suffered from chronic pain and psychological impairments, and had pre-existing conditions warranting removal from the MIG.

The Tribunal found the applicant's evidence insufficient to establish chronic pain or psychological impairment exceeding the MIG, noting inconsistencies and lack of objective evidence.

The Tribunal also found no compelling evidence that pre-existing conditions would prevent maximal recovery within the MIG.

The application for medical benefits and interest was dismissed.

The applicant sought payment for a $2,065.00 chiropractic treatment plan following a 2016 motor vehicle accident.

The respondent insurer denied the benefit, arguing the applicant had reached maximum medical recovery.

The Tribunal found that the applicant failed to prove the treatment was reasonable and necessary, noting that her ongoing pain was likely attributable to pre-existing juvenile rheumatoid arthritis rather than the accident.

The application was dismissed.