Dr. J.H. Ennis

The applicant sought a determination that he sustained a catastrophic impairment due to a mental or behavioural disorder following a motor vehicle accident.

The Tribunal applied the Pastore three-step approach and assessed the applicant's functioning in four domains.

Relying on surveillance evidence and the respondent's expert assessments, the Tribunal found the applicant sustained only mild to moderate impairments in the four domains.

The application was dismissed as the applicant failed to meet the threshold for catastrophic impairment.

The applicant was injured in multiple motor vehicle accidents, most notably in September 1996.

She claimed the cost of psychological treatment, which the insurer denied, arguing the need for treatment arose from subsequent accidents or life events.

The arbitrator found that the applicant's need for psychological treatment largely stemmed from the September 1996 accident and that the treatment was reasonable and necessary.

The arbitrator also found that the insurer unreasonably withheld and delayed payment of the benefits, failing to comply with its obligation to pay pending resolution of the dispute and failing to arrange a timely assessment.

The applicant was awarded the cost of the treatment, interest, and a special award of $5,000.