Faye Perreras

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, funding for a psychological assessment, and physiotherapy services.

The respondent denied the benefits.

The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that she suffered a complete inability to carry on a normal life, noting inconsistencies in her self-reporting and a failure to provide evidence of her pre-accident activities.

The Tribunal assigned little weight to the applicant's expert reports due to methodological flaws and reliance on incomplete medical records.

The claims for the remaining balances of the psychological assessment and physiotherapy services were dismissed as they exceeded the maximum amounts permitted under the Schedule and Guidelines.

The application was dismissed in its entirety.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule, which the respondent insurer denied.

The Licence Appeal Tribunal found the applicant was entitled to two treatment plans for chiropractic services, as the medical evidence supported her ongoing symptoms from an ankle fracture, and the insurer's expert reports were given little weight.

The Tribunal also approved the unapproved balance of two psychological treatment plans, preferring the treating psychologist's recommendation for 1.5-hour sessions over the insurer's expert's 1.0-hour recommendation.

However, the Tribunal denied a third psychological treatment plan because the applicant failed to attend a scheduled insurer's examination, barring her claim under s. 55(1)(2) of the Schedule.

Claims for travel expenses and an occupational therapy assessment were also dismissed due to insufficient evidence.

The Tribunal declined to order a special award under s. 10 of Reg. 664, finding the insurer's reliance on its expert reports was not unreasonable.