Applicant with severe traumatic brain injury found catastrophically impaired and entitled to post-104 week IRBs.
The applicant was involved in a motor vehicle accident and sustained a severe traumatic brain injury.
He applied to the Licence Appeal Tribunal after the respondent insurer denied his claims for catastrophic impairment, post-104 week income replacement benefits, and various treatment plans.
The Tribunal found that the applicant sustained a catastrophic impairment under Criterion 4, as his GOS-E assessment demonstrated a Lower Moderate Disability due to his inability to work and constant disruption to relationships.
The Tribunal also awarded post-104 week income replacement benefits, finding the applicant completely unable to engage in suitable employment due to cognitive and emotional impairments.
The claims for treatment plans were dismissed as the applicant failed to make submissions on their reasonableness and necessity.
OLATOntario Licence Appeal TribunalDec 5, 2025
