Dr. Gozlan

The applicant was struck by a vehicle as a pedestrian and sought statutory accident benefits, including non-earner benefits and various medical and rehabilitation treatment plans.

The Licence Appeal Tribunal dismissed the claim for non-earner benefits, finding that the applicant's functionality had improved and he did not suffer a complete inability to carry on a normal life, as evidenced by his return to post-secondary education and independence with self-care.

The Tribunal approved treatment plans for a chronic pain assessment and a functional abilities evaluation, finding them reasonable and necessary to investigate ongoing impairments.

The remaining claims for treatment plans and an award for unreasonable delay were dismissed.

The applicant sought medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a 2017 motor vehicle accident.

The respondent insurer denied treatment plans for psychological services, a gym membership, a Weight Watchers program, and physiotherapy.

The Tribunal found that the applicant failed to demonstrate the proposed treatments were reasonable and necessary as a result of the accident.

The medical evidence, including clinical notes from treating physicians, indicated that the applicant's accident-related injuries had resolved and that her ongoing complaints, including weight gain and soft tissue pain, were attributable to an unrelated endocrine disorder.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident.

The Licence Appeal Tribunal considered claims for occupational therapy, a vocational assessment, and psychological services.

The Tribunal denied the vocational assessment, noting the applicant continued to work as a personal support worker.

The claim for occupational therapy was largely denied, save for a medication docette, as the applicant failed to prove the necessity of the remaining items.

However, the Tribunal granted the claim for psychological services, applying the 'but for' test to find the accident was a necessary cause of the applicant's psychological impairments, despite subsequent unrelated personal tragedies.

Interest was awarded on the approved benefits.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to non-earner benefits and medical benefits for psychological and chiropractic services.

The insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that she failed to comply with section 33 requests for information.

The Tribunal found that the applicant's non-compliance with section 33 relieved the insurer of liability for non-earner benefits.

Furthermore, the Tribunal concluded the applicant sustained predominantly minor injuries, as she failed to prove pre-existing conditions, psychological impairments, or chronic pain that would warrant removal from the MIG.

Consequently, the disputed treatment plans were not reasonable and necessary as they exceeded the $3,500 MIG limit.

The application was dismissed.

This costs endorsement addresses several pre-trial and mid-trial motions, as well as costs thrown away, following a mistrial declared due to the plaintiff's health crisis.

The court considered motions regarding venue transfer, exclusion of surveillance evidence, expert and non-party expert witnesses, and two motions for mistrial.

The court applied principles of costs following the event and the factors under Rule 57.01(1), and specifically addressed "costs thrown away" in the context of a mistrial not caused by fault but by the responsibility of a party due to an unforeseen health event.

The plaintiff was awarded costs for the surveillance and expert witness motions, while the defendant was awarded costs for their mistrial motion and substantial indemnity for costs thrown away.

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits, which the insurer denied on the basis that her injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that while the applicant's physical injuries were predominantly minor, she demonstrated on a balance of probabilities that she suffers from chronic pain syndrome with a psychological component, warranting removal from the MIG.

The Tribunal ordered payment for one physiotherapy treatment plan, psychological assessment and treatment, and prescription expenses, finding them reasonable and necessary to address her chronic pain.

The remaining treatment plans and assessments were denied as redundant or unnecessary, and the claim for a special award was dismissed as the insurer had a genuine dispute.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision, claiming entitlement to income replacement benefits (IRBs), medical benefits, and the cost of a psychological assessment.

The respondent argued the applicant suffered only minor injuries subject to the Minor Injury Guideline (MIG).

The Tribunal found that the applicant sustained a mild concussion, removing him from the MIG.

However, the Tribunal dismissed the claim for IRBs, finding insufficient evidence that the applicant's soft tissue injuries or concussion caused a substantial inability to perform the essential tasks of his pre-accident employment as a cabinet-maker.

Claims for physiotherapy, chiropractic treatment, and assistive devices were denied as not reasonable and necessary.

The Tribunal granted the cost of a psychological assessment, finding it reasonable based on an initial screening.

The Tribunal also awarded $150 in costs to the respondent due to the applicant's breach of a direction not to communicate with a witness during the hearing.

The applicant sought income replacement benefits, medical benefits, and a determination of catastrophic impairment following a 2008 motor vehicle accident.

The arbitrator dismissed the claims, finding the applicant failed to prove a complete inability to engage in employment for the IRB claim.

The medical benefit claim was not properly linked to the 2008 accident.

The catastrophic impairment claim failed because the applicant's assessments did not properly account for pre-existing conditions as required by the AMA Guides, and the evidence did not establish a marked impairment resulting directly from the 2008 accident.

The applicant was injured in a motor vehicle accident and sought ongoing Income Replacement Benefits (IRBs), medical and rehabilitation benefits outside the Minor Injury Guideline (MIG), and a Special Award.

The arbitrator found that the applicant suffered a substantial inability to perform his pre-accident employment for the first 104 weeks, entitling him to IRBs for that period.

However, the applicant failed to prove a complete inability to engage in any suitable employment beyond the two-year mark.

The arbitrator also concluded that the applicant's injuries, including alleged chronic pain and psychological impairments, did not remove him from the MIG, as the insurer's medical evidence demonstrating no objective impairment was preferred.

The claims for additional treatment plans and a Special Award were dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement, medical, attendant care, and housekeeping benefits.

The insurer denied the benefits, arguing the accident was not severe enough to cause the impairments.

The Arbitrator found that the applicant's shoulder tear was caused by the accident and required surgery.

The Arbitrator awarded income replacement, housekeeping, and attendant care benefits for a fixed period surrounding the surgery and recovery, as well as medical benefits and costs of examinations.

The claim for a special award was dismissed because the insurer's initial denial was based on inconclusive evidence at the time.

The applicant sought expenses following an arbitration where she had mixed success in claiming statutory accident benefits.

The insurer argued that it enjoyed a greater degree of success and that the applicant unnecessarily prolonged the proceeding by calling six expert witnesses and being tardy in providing medical and financial records.

The arbitrator found that while the applicant's success was mixed, she was forced to proceed with the arbitration to obtain any benefits, as the insurer refused to acknowledge liability until the eve of the hearing.

The arbitrator awarded the applicant her reasonable expenses, with some reductions for unnecessary testimony and excessive preparation time, totaling $20,637.64 inclusive of fees and disbursements.

The appellant sought to appeal an arbitrator's preliminary order denying his request for interim legal expenses to fund a rebuttal catastrophic impairment assessment.

The arbitrator had found that while the appellant met the test for interim legal expenses, the $50,000 limit on medical and rehabilitation benefits under section 18 of the 2010 Schedule precluded the award.

The Director's Delegate exercised discretion to accept the appeal, finding that it raised a novel and broadly important issue of whether the statutory benefit maximums apply to interim expense awards under the Insurance Act.

The applicant, who was injured in a motor vehicle accident, sought an interim order requiring the insurer to fund a rebuttal catastrophic impairment assessment.

The insurer had already paid the $50,000 maximum in medical and rehabilitation benefits for non-catastrophic injuries.

The arbitrator found that while the applicant met the criteria for an interim expense award—raising a bona fide issue, demonstrating the expense was reasonable and necessary, and showing financial inability to pay—the request was barred by the statutory limits.

Because the cost of assessments is included in the medical and rehabilitation benefits limit under the Schedule, the arbitrator could not order the insurer to exceed the $50,000 cap.

The motion was dismissed with no order as to expenses.