Dr. Spivak

The respondent insurer requested a reconsideration of a Licence Appeal Tribunal decision which found that the insured's injuries fell outside the Minor Injury Guideline (MIG) and awarded treatment plans, interest, and a 30% award under s. 10 of Regulation 664.

The insurer argued that the adjudicator erred in fact and law by preferring the evidence of the insured's medical assessor over its own, by finding the insured suffered from chronic pain, and by granting the award.

The Tribunal dismissed the request for reconsideration, holding that the adjudicator made no errors of fact or law but rather properly exercised their jurisdiction to weigh the conflicting medical evidence.

The Tribunal noted that a reconsideration is not an opportunity to re-litigate a party's position or challenge the weight assigned to evidence.

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) until the insurer terminated them.

Prior to the arbitration hearing, the insurer conceded the issue and paid the IRBs retroactively.

The arbitrator held that interest on the overdue IRBs began to accrue from the date they were initially terminated, as the insurer bears the consequence of a decision not to pay benefits later found owing.

The arbitrator also awarded a special award of $36,280.00, finding the insurer acted unreasonably by ignoring the conclusions of its own medical and vocational assessors, who noted that the alternative job options proposed did not provide the same remuneration as the applicant's pre-accident employment.

The insurer was ordered to pay $25,000.00 in expenses.

The applicant sought accident benefits following a motor vehicle accident.

The insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that her injuries, including drop attacks, a knee injury, chronic pain, and psychological issues, removed her from the MIG.

The Tribunal found that the applicant failed to establish on a balance of probabilities that her drop attacks and knee injury were caused by the accident, applying the 'but for' test.

Furthermore, the applicant did not provide compelling evidence of a pre-existing psychological condition that would prevent maximal recovery.

As the applicant's injuries were predominantly minor and she had exhausted the $3,500 MIG limit, her claims for further chiropractic services and interest were dismissed.