Dr. Thomas Steeves

The applicant sought entitlement to various statutory accident benefits following a motor vehicle accident, including treatment plans for psychological, physiotherapy, and chiropractic services, as well as catastrophic assessments and medical expenses.

The Licence Appeal Tribunal found the psychological and physiotherapy treatment plans to be reasonable and necessary, supported by extensive medical evidence, and noted the insurer's failure to provide proper notice of denial for one plan.

However, the Tribunal denied the chiropractic plan as there was no proof it was submitted, denied the catastrophic assessments as the unapproved file reviews were not standalone assessments, and denied the medical expenses incurred in China as they were submitted late and not proven reasonable and necessary.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a chronic pain assessment and a functional assessment, as well as a special award for unreasonable delay.

The Licence Appeal Tribunal found the chronic pain assessment to be reasonable and necessary, preferring the evidence of the applicant's assessors over the respondent's assessors.

However, the Tribunal denied the functional assessment because it was based solely on a telephone consultation.

The claim for a special award was also dismissed as the respondent's denial did not constitute unreasonable conduct.