Dr. Zarnett

The applicant sought statutory accident benefits, claiming he suffered physical and psychological injuries when he jumped out of the way of a reversing vehicle.

The respondent denied the claim on the basis that the incident was not an 'accident' under s. 3(1) of the Statutory Accident Benefits Schedule.

The Tribunal found that the applicant's alleged injuries did not arise out of the ordinary use or operation of an automobile, failing the purpose test.

The medical evidence showed significant pre-existing conditions and no contemporaneous reports of injury, undermining the applicant's credibility.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including funding for chiropractic and psychological treatment plans, and argued for removal from the Minor Injury Guideline (MIG) due to chronic pain and psychological impairments.

The adjudicator found that the applicant's physical injuries were predominantly minor, consisting of sprains and strains, and that the evidence did not support a chronic pain diagnosis sufficient to warrant removal from the MIG.

Relying on the insurer's psychological assessment, the adjudicator also found no diagnosable psychological condition.

Consequently, the applicant failed to meet the burden of proving entitlement to treatment outside the MIG, and the disputed treatment plans were deemed not reasonable and necessary.

The application was dismissed.

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

The respondent denied various medical benefits and examination costs on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The Licence Appeal Tribunal found that the applicant sustained predominantly minor physical injuries, such as uncomplicated myofascial strains and contusions.

The applicant failed to prove on a balance of probabilities that he suffered from a concussion, chronic pain, or psychological impairments that would remove him from the MIG.

As the MIG limit was already exhausted, the claims for additional medical benefits and examination costs were dismissed.

The applicant sought payment for various medical treatments, assessments, disability certificates, and Income Replacement Benefits (IRBs) following a motor vehicle accident.

The insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The adjudicator found that the applicant failed to prove on a balance of probabilities that he suffered from chronic pain or a psychological impairment that would remove him from the MIG.

Consequently, the claims for medical benefits and assessments were denied.

Furthermore, while the applicant may have been entitled to IRBs, he failed to provide sufficient financial records to calculate the quantum, resulting in an award of $0 per week.

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits.

The respondent insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit was exhausted.

The Licence Appeal Tribunal found that the applicant had a pre-existing elbow condition that was exacerbated by the accident, preventing him from achieving maximal recovery within the MIG limits.

The Tribunal also found the disputed treatment plans for chiropractic, physiotherapy, and a psychological assessment to be reasonable and necessary, ordering the insurer to pay the benefits with interest.

The applicant sought income replacement benefits (IRBs) and various medical benefits following a motor vehicle accident.

The insurer terminated IRBs and denied further medical benefits on the basis that the applicant's injuries were predominantly minor and the $3,500 Minor Injury Guideline (MIG) limit had been exhausted.

The Tribunal found that the applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident employment, relying on insurer examinations that showed her impairment was temporary and self-limited.

The Tribunal also held that the applicant failed to provide compelling medical evidence that her pre-existing conditions prevented her from achieving maximal recovery under the MIG.

The application was dismissed.

The Applicant sought her expenses and a Special Award following a successful arbitration for statutory accident benefits against the Insurer.

The Arbitrator found that the Insurer unreasonably withheld and delayed payments for Non-Earner and Medical Benefits despite compelling medical evidence from the Applicant's experts.

The Insurer's conduct, including an inadequate all-inclusive settlement offer, warranted a Special Award.

The Arbitrator ordered the Insurer to pay the Applicant's expenses fixed at $28,415.06 plus HST, and a Special Award of $13,000.00 inclusive of interest.

The applicant was injured in a motor vehicle accident and sought income replacement benefits, housekeeping benefits, and payment for treatment.

The insurer terminated benefits based on medical assessments indicating full recovery.

The arbitrator dismissed the application, finding the applicant failed to prove she was substantially unable to perform her pre-accident employment or housekeeping duties.

The arbitrator preferred the insurer's medical evidence, noting the applicant's lack of supporting medical records, inconsistent testimony, and surveillance evidence showing her working.