Dr. Cayen

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits.

The respondent insurer denied the benefits, arguing the applicant's injuries were predominantly minor and subject to the $3,500 limit of the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant's meniscal tear and unopposed psychological diagnoses warranted removal from the MIG.

However, the Tribunal only approved one treatment plan for $2,800, finding the applicant failed to provide sufficient evidence to prove the remaining claimed expenses were reasonable and necessary.

The applicant was injured in a motor vehicle accident and sought an income replacement benefit (IRB) and various medical and rehabilitation benefits from the respondent insurer.

The insurer terminated the IRB and denied several treatment plans on the basis that the applicant no longer suffered a substantial inability to perform his pre-accident job tasks and that the treatments were not reasonable and necessary.

The Tribunal found that the applicant failed to prove a substantial inability to perform his employment tasks during the disputed period, relying on the insurer's expert assessments.

The Tribunal approved one chiropractic treatment plan as reasonable and necessary, noting the applicant's ongoing pain and the insurer's failure to conduct a timely examination, but denied the remaining plans for chiropractic, psychological, and occupational therapy services due to a lack of corroborating medical evidence.

The applicant sought income replacement benefits and funding for a psychological treatment plan following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove on a balance of probabilities that he suffered a substantial inability to perform the essential tasks of his pre-accident employment as a security guard.

The Tribunal preferred the insurer's psychological assessment, which found no ongoing psychological impairment, and concluded the proposed treatment plan was not reasonable and necessary.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits and a physiotherapy treatment plan.

The respondent denied the claims, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that he did not suffer a substantial inability to perform his pre-accident employment.

The Tribunal found that the applicant sustained predominantly minor soft tissue injuries and failed to provide compelling evidence to remove him from the MIG.

As the $3,500 limit was exhausted, the physiotherapy claim was denied.

The Tribunal also dismissed the claim for income replacement benefits, preferring the detailed reports of the respondent's assessors over the applicant's initial disability certificate.

The respondent's claim for costs was dismissed.