Dr. Hillel Finestone

The applicant sought statutory accident benefits following a motor vehicle accident while a passenger on a bus.

The Licence Appeal Tribunal found that four treatment plans for assistive devices and occupational therapy were reasonable and necessary, given the applicant's physical and cognitive decline post-accident.

However, the Tribunal denied two treatment plans for physiotherapy and kinesiology, finding that the applicant had not benefited from past physical therapy and was unlikely to engage in it due to other health issues and personal behaviours.

The Tribunal also denied the applicant's request for an award, finding no unreasonable conduct by the insurer.

The applicant, a taxi driver, was injured in a motor vehicle accident and sought income replacement benefits (IRBs) and a special award.

The insurer terminated benefits based on a DAC assessment.

At the hearing, the insurer conceded entitlement, leaving the quantum of IRBs and the special award in dispute.

The arbitrator determined the applicant's gross annual income by including employer-paid EI premiums and a 5.5% allowance for tips, but rejected the applicant's claim for unrecorded cash fares due to a lack of corroborating documentation.

The claim for a special award was dismissed, as the insurer reasonably relied on its medical experts in maintaining its denial until the hearing.

The applicant was injured in a motor vehicle accident and claimed ongoing caregiver benefits, housekeeping expenses, psychological counselling, and a special award after the insurer terminated her benefits.

The arbitrator found that the applicant suffered a substantial inability to perform caregiver tasks due to physical and psychological impairments until her condition stabilized in January 1999, awarding caregiver benefits for that period.

The arbitrator also awarded a nominal amount for housekeeping expenses and an $8,000 special award, finding the insurer unreasonably terminated psychological counselling and vocational retraining benefits without a reasonable basis.

The applicant was injured in a motor vehicle accident and received weekly income benefits until they were terminated by the insurer.

The applicant sought arbitration, arguing that the benefits were terminated prematurely and that she met the post-156 week eligibility test.

The arbitrator held that the 156-week period in section 12(5)(b) of the Statutory Accident Benefits Schedule refers to 156 weeks of disability, meaning the benefits were not terminated prematurely.

Furthermore, the arbitrator found that the applicant was capable of returning to full-time employment with restrictions and had not made a bona fide effort to find suitable employment.

The application for ongoing weekly income benefits was dismissed.

The applicant was injured in a motor vehicle accident and received weekly income benefits until the insurer terminated them, claiming she was no longer substantially unable to perform the essential tasks of her pre-accident employment as a server and cashier.

The arbitrator found that the applicant remained substantially unable to perform the heavy aspects of her work as a server and was therefore entitled to ongoing weekly income benefits.

The arbitrator also determined the proper calculation of her pre-accident income, including an estimate of her tip income, and awarded a special award of $1,500 against the insurer for unreasonably handling the tips issue.