Dr. T. Dumitrascu

The applicant was injured in a motor vehicle accident and sought accident benefits, which the respondent insurer denied on the basis that her injuries fell within the Minor Injury Guideline (MIG).

The applicant applied to the Licence Appeal Tribunal, arguing she should be removed from the MIG due to psychological injuries and chronic pain.

The Tribunal found insufficient evidence of a psychological injury, preferring the respondent's psychological assessment over the applicant's, and noted a lack of contemporaneous medical evidence supporting chronic pain.

The Tribunal concluded the applicant's injuries were predominantly minor, subject to the MIG limit, and dismissed the claims for psychological treatment, assessment, and interest.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to medical benefits for chiropractic and psychological treatment, as well as income replacement benefits.

The insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and that she was not substantially unable to perform her employment tasks.

The Licence Appeal Tribunal found that the applicant did not suffer from an accident-related psychological injury or chronic pain condition, preferring the insurer's medical examinations over the applicant's expert.

The Tribunal concluded the applicant sustained a minor injury subject to the $3,500 funding limit and dismissed the claims for additional medical benefits, income replacement benefits, and interest.

The applicant sought removal from the Minor Injury Guideline (MIG) following a motor vehicle accident, claiming a psychological impairment.

The Tribunal found the applicant's psychological evidence unpersuasive, noting inconsistencies in the expert report and standard test results indicating minimal depression and anxiety.

The Tribunal concluded the applicant failed to prove a psychological impairment warranting removal from the MIG and denied the disputed treatment plans beyond the $3,500 limit.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent insurer denied several treatment and assessment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been exhausted.

The applicant applied to the Licence Appeal Tribunal, arguing that pre-existing knee pain, chronic pain, and psychological injuries warranted removal from the MIG.

The Tribunal found no compelling evidence that the pre-existing condition precluded recovery, and preferred the respondent's medical assessors over the applicant's assessors regarding chronic pain and psychological injuries.

The Tribunal concluded the applicant sustained predominantly minor injuries, was subject to the MIG, and was not entitled to the disputed treatment plans as the funding limit was exhausted.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision.

The respondent insurer denied funding for a psychological assessment and treatment plan, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant suffered from accident-related psychological injuries, including post-traumatic stress disorder, which removed him from the MIG.

The Tribunal ordered the respondent to pay for the disputed psychological assessment and treatment plan, along with interest, but denied the applicant's request for an award under Regulation 664, finding the insurer's initial denials were not unreasonable.

The appellant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that his injuries fell within the Minor Injury Guideline (MIG) and its $3,500 cap.

The appellant argued he suffered from chronic pain and psychological impairments, and had pre-existing conditions preventing maximal recovery within the MIG.

The Licence Appeal Tribunal found the medical evidence, including clinical notes and insurer's examinations, did not support a finding of more than predominantly minor injuries.

The Tribunal also found no compelling evidence that the appellant's pre-existing conditions hindered his recovery.

As the appellant had not incurred expenses beyond the cap, the disputed treatment plans, interest, and costs were denied.

The insurer appealed an arbitrator's decision awarding the insured, a minor who sustained a catastrophic brain injury, private school tuition as a rehabilitation benefit and a $28,000 special award for unreasonably withholding benefits.

The Director's Delegate upheld the tuition award, finding no error in the arbitrator's conclusion that the expense was reasonable, necessary, and 'incurred' under the Schedule despite not being paid upfront.

The Delegate also upheld the entitlement to a special award, noting the insurer unreasonably relied on preliminary and flawed expert reports to deny benefits.

However, the Delegate set aside the quantum of the special award and remitted it to arbitration, finding the arbitrator failed to provide sufficient reasons explaining how the $28,000 figure was calculated.