Dr. Diana Velikonja

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

The insurer denied two treatment plans for a neurocognitive assessment and a psychological assessment, arguing they were duplicative and subject to the $2,000 statutory cap for a single assessment under s. 25(5)(a) of the Schedule.

The Tribunal found that the two assessments, although contained within the same report, were distinct, stand-alone evaluations addressing separate cognitive and psychological impairments.

The Tribunal ordered the insurer to pay the outstanding $2,200.00 for the assessments, plus interest.

The applicant sought a determination that he sustained a catastrophic impairment as a result of a motor vehicle accident, along with entitlement to attendant care and various medical and rehabilitation benefits.

The Licence Appeal Tribunal found that the applicant failed to prove a catastrophic impairment under Criterion 7, as his whole person impairment rating fell below the 55% threshold.

Consequently, the claim for attendant care benefits beyond the 104-week mark was denied.

However, the Tribunal ruled that the cost of a multidisciplinary catastrophic impairment assessment does not count towards the non-catastrophic medical and rehabilitation limits.

The Tribunal partially granted the claims for physiotherapy, chiropractic treatment, and specific assessment costs, while denying claims for an iPad, rehabilitation therapy, and an award for unreasonably withheld benefits.

The Applicant was severely injured in a motorcycle accident and applied for statutory accident benefits.

The Insurer raised a preliminary issue that the Applicant was precluded from claiming benefits because he was driving without valid insurance.

The Arbitrator found that the Applicant, who had purchased what he believed to be a legitimate policy from a third party, reasonably believed he was insured.

On the substantive issues, the Arbitrator awarded pre-104 income replacement benefits, finding the Applicant suffered a substantial inability to perform his pre-accident employment tasks due to cognitive and physical impairments.

However, the claim for post-104 income replacement benefits was dismissed as the Applicant had returned to work and earned more than his pre-accident income.

The Arbitrator also awarded attendant care benefits, finding the Applicant's family members sustained an economic loss, and granted ongoing housekeeping and home maintenance benefits.

The applicant was injured in a motor vehicle accident and sought accident benefits, claiming he sustained a catastrophic impairment.

The insurer denied the claim, arguing that any catastrophic impairment was the result of a stroke the applicant suffered two years after the accident.

The arbitrator found that the applicant's psychological impairments resulting from the accident met the threshold for catastrophic impairment, and that the accident materially contributed to the stroke.

The arbitrator awarded attendant care benefits for incurred professional services but denied them for family-provided care due to a lack of evidence of economic loss.

A special award was granted against the insurer for unreasonably withholding payments.