Dr. S. Soriano

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits, as well as the costs of several assessments, which the respondent insurer denied.

The Licence Appeal Tribunal found that the proposed chiropractic and psychological treatment plans, along with a chronic pain assessment, were reasonable and necessary given the applicant's ongoing pain and psychological symptoms.

However, the Tribunal concluded that a cognitive assessment and a driver's reintegration assessment were not reasonable and necessary, as the applicant did not exhibit cognitive impairment and the driving phobia could be addressed through the approved psychological treatment.

The applicant was awarded interest on overdue payments, and no costs were awarded to either party.

The applicant was injured in a motor vehicle accident and sought a determination of catastrophic impairment under the Statutory Accident Benefits Schedule.

The arbitrator found that the applicant sustained a catastrophic impairment under both the 55% whole person impairment (WPI) threshold (clause 2(1.2)(f)) and the marked impairment threshold for mental or behavioural disorders (clause 2(1.2)(g)).

The arbitrator accepted the applicant's physical impairment rating of 48% WPI and assessed her mental and behavioural impairment at 33% WPI, resulting in a combined 65% WPI.

The arbitrator also found a marked impairment in three of four functional spheres.

Regarding the claimed expenses totaling $83,417.90, the arbitrator awarded only $1,925.00 for a mental health assessment, dismissing the remainder because they were not properly submitted through the HCAI system as required by the Schedule.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits, specifically non-earner benefits, from the insurer.

The parties proceeded to arbitration at the Financial Services Commission of Ontario.

The arbitrator applied the principles from Heath v. Economical Mutual Insurance Co. to determine whether the applicant suffered a complete inability to carry on a normal life.

The arbitrator found that the applicant failed to prove that the accident continuously prevented her from engaging in substantially all of her pre-accident activities, as she continued to perform most of her usual activities despite increased pain.

The application for non-earner benefits and interest was dismissed, and the issue of expenses was deferred.