Dr. Omar Dessouki

The plaintiff sought long-term disability (LTD) benefits and general damages for breach of contract, claiming total disability due to chronic back and leg pain, anxiety, and depression.

The plaintiff had not submitted a formal LTD application, seeking relief from forfeiture.

The court granted relief from forfeiture, finding imperfect compliance.

However, the court ultimately dismissed the plaintiff's claim for LTD benefits and general damages, finding that he failed to prove total disability as defined by the policy, largely due to inconsistencies between his subjective complaints, objective medical evidence, video surveillance, and his work history.

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

The respondent denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued she should be removed from the MIG due to chronic pain syndrome, psychological impairments, and pre-existing conditions including depression and drug addiction.

The Tribunal found the applicant's evidence insufficient to establish chronic pain with functional impairment or a psychological condition precluding recovery within the MIG.

The Tribunal preferred the in-person assessments of the respondent's experts over the virtual assessments of the applicant's experts.

The application was dismissed, with the applicant entitled only to any remaining funds within the $3,500 MIG limit.

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits, which the respondent insurer denied on the basis that the injuries fell within the Minor Injury Guideline (MIG).

The applicant applied to the Licence Appeal Tribunal for dispute resolution.

The Tribunal found that while the initial physical injuries were predominantly minor, the applicant subsequently developed chronic pain with accompanying psychological impairment, removing him from the MIG.

The Tribunal concluded that the disputed treatment plans for chiropractic and psychological services were reasonable and necessary, and ordered the respondent to pay the benefits with interest.

The applicant sought statutory accident benefits for chiropractic treatment following a motor vehicle accident.

The insurer denied the treatment plans, arguing the injuries were pre-existing.

The Licence Appeal Tribunal found that the insurer complied with the notice requirements under section 38(8) of the Schedule.

Applying the 'but for' test, the Tribunal concluded that the applicant's shoulder, neck, chest, and back pain pre-existed the accident and were not caused by it.

The application for benefits and interest was dismissed.

The applicant was injured in a rear-end motor vehicle accident and sought medical and attendant care benefits from the respondent insurer.

The adjudicator denied the claim for attendant care benefits, finding the applicant failed to incur the expenses.

However, the adjudicator granted entitlement to four physiotherapy treatment plans, a psychological treatment plan, a functional impairment assessment, and a chronic pain assessment, finding them reasonable and necessary.

The adjudicator also awarded a 20% special award under Regulation 664 regarding the functional impairment assessment, concluding the insurer unreasonably withheld approval by relying on an assessor's unconvincing change of opinion.