Dr. N. Philips

The applicant sought statutory accident benefits following a motor vehicle accident, claiming she sustained a catastrophic impairment due to psychological and neurological injuries.

The Licence Appeal Tribunal found that the applicant did not meet the criteria for a catastrophic impairment, as her mental and behavioural impairments did not reach the marked level in three or more spheres of function.

The Tribunal preferred the respondent's expert evidence, noting the applicant's self-reported independence in activities of daily living.

Claims for attendant care benefits, a neurological assessment, unapproved assessment costs, and an award for unreasonable withholding of benefits were all dismissed.

The applicant sought statutory accident benefits following an accident involving an all-terrain vehicle.

The insurer denied benefits, including income replacement benefits, attendant care benefits, and a determination of catastrophic impairment.

The Tribunal found the applicant was excluded from receiving income replacement benefits because he was operating an uninsured vehicle without a valid license.

The Tribunal also dismissed the claims for catastrophic impairment and other benefits, finding the applicant's self-reporting to medical assessors was unreliable and contradicted by video surveillance showing a higher level of functioning than reported.

The applicant was injured in a motor vehicle accident and sought a determination that she sustained a catastrophic impairment under Criterion 8 (mental or behavioural disorder) of the Statutory Accident Benefits Schedule.

The respondent denied the claim, relying on its psychiatric assessor who found only mild to moderate impairments.

The Tribunal preferred the evidence of the applicant's assessors, noting that they appropriately included pain-related impairments and relied on functional occupational therapy assessments which demonstrated the applicant's significant deterioration when challenged by tasks.

The Tribunal concluded the applicant suffered marked impairments in three of four functional domains and declared her catastrophically impaired.