Dr. Gianni Maistrelli

The applicant sought $3,638.00 for a chiropractic treatment plan following a motor vehicle accident.

The respondent insurer denied the plan, relying on an insurer's examination by an orthopedic surgeon who concluded the applicant sustained only minor soft tissue injuries.

The Tribunal found the applicant failed to prove the treatment was reasonable and necessary, noting a lack of objective medical evidence, a significant pre-existing workplace injury, and the persuasiveness of the insurer's examination.

The application was dismissed.

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

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

The applicant sought removal from the MIG on the basis of chronic pain and psychological injuries, and claimed entitlement to an income replacement benefit (IRB) and various treatment plans.

The Tribunal found that the applicant failed to demonstrate chronic pain with a functional impairment or a psychological impairment that would warrant removal from the MIG.

The Tribunal also found that the applicant did not meet the burden of proving a substantial inability to perform the essential tasks of his employment, and therefore was not entitled to an IRB.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought a non-earner benefit, which the respondent insurer denied.

The Tribunal applied the Heath test to compare the applicant's pre- and post-accident activities.

Finding the applicant's evidence credible and preferring the applicant's psychological expert over the insurer's assessors, the Tribunal concluded that the applicant's accident-related impairments, including severe sleep deprivation, panic attacks, and driving anxiety, continuously prevented her from engaging in substantially all of her pre-accident activities.

The Tribunal ordered the respondent to pay the non-earner benefit of $185.00 per week from May 27, 2016, ongoing, plus interest.

The insurer requested a reconsideration of a Licence Appeal Tribunal decision that awarded the insured physiotherapy services, orthopaedic and psychiatric assessments, and a special award under s. 10 of Regulation 664.

The Executive Chair found no significant error of law in the adjudicator's determination that the treatment plans and assessments were reasonable and necessary for managing the insured's chronic pain.

However, the Executive Chair allowed the reconsideration regarding the s. 10 award, finding that the adjudicator erred by conflating the reasonableness of the treatment plans with the unreasonableness of the insurer's conduct.

The award was overturned as there was no evidence the insurer unreasonably withheld or delayed payments.

The applicant, an elderly pedestrian who was struck by a motor vehicle in a parking lot, applied for statutory accident benefits including non-earner benefits, attendant care benefits, and medical/rehabilitation benefits.

The adjudicator dismissed the application in its entirety.

The adjudicator found that the applicant failed to prove she suffered a complete inability to carry on a normal life, noting inconsistencies in her self-reporting and relying on insurer's examinations that found no objective impairment preventing her pre-accident activities.

Claims for attendant care and medical benefits were similarly dismissed due to a lack of persuasive medical evidence and inconsistencies in the applicant's submitted treatment plans.

The applicant sought statutory accident benefits, including non-earner benefits, medical benefits for psychological services, chronic pain treatment, physiotherapy, and assessments, following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove her entitlement to the benefits.

The Tribunal gave substantial weight to the respondent's insurer's examination reports, noting that the applicant's self-reporting to her own experts was inconsistent with her statements to the respondent's assessors, undermining her claims of complete inability to carry on a normal life, psychological impairment, and chronic pain syndrome.

The applicant's requests for interest and a special award were also denied.

The applicant sought statutory accident benefits for physiotherapy services and orthopaedic and psychiatric assessments following a motor vehicle accident.

The respondent insurer denied the claims based on insurer examinations.

The adjudicator found that the physiotherapy services were reasonable and necessary for managing the applicant's chronic pain, rejecting the insurer's argument that treatment must lead to full recovery.

The adjudicator also approved the assessments, noting the insurer's assessors conducted paper reviews without reviewing key medical reports.

Finding that the insurer unreasonably withheld payments, the adjudicator ordered a special award of 50% of the disputed amounts, plus interest.

The plaintiff was rear-ended in a motor vehicle accident and claimed soft tissue damages, chronic pain, anxiety, and depression.

The defendant admitted liability, and the sole issue at trial was damages.

The trial judge qualified a defence psychiatrist as an expert despite serious reservations about his methodology and independence.

The expert's testimony focused primarily on alleged inconsistencies between what the plaintiff told him and her medical records, essentially attacking her credibility rather than providing independent psychiatric assessment.

The jury awarded only general damages of $23,500 and rejected all other heads of damages.

On appeal, the court found the trial judge failed to properly discharge his gatekeeper duty by not conducting a cost-benefit analysis at the qualification stage and failed to exercise his ongoing gatekeeper function when the expert's lack of impartiality became apparent during testimony.

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits for physiotherapy and various assessments.

The insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the policy limits had been exhausted.

The applicant argued that a pre-existing shoulder injury and psychological issues removed her from the MIG.

The arbitrator found insufficient evidence of a documented pre-existing condition that would prevent maximal recovery within the MIG limits, and concluded the psychological issues were mild and did not warrant removal from the MIG.

The claims for treatment, assessments, a special award, and interest were all dismissed.

The applicant, a pedestrian whose foot was run over by a car, sought weekly no-fault benefits after the insurer terminated them.

During the arbitration, the insurer attempted to introduce undisclosed surveillance video to impeach the applicant's credibility.

The arbitrator excluded the video, applying the rule in Browne v. Dunn, because the insurer failed to put the evidence to the applicant during cross-examination, which would cause undue prejudice and delay in an arbitration context.

On the merits, the arbitrator found that while the applicant suffered discomfort from his injuries, he failed to establish a substantial inability to perform his essential tasks.

The application for weekly benefits and interest was dismissed.