Dr. Gregory Soon-Shiong

The applicant sought a non-earner benefit and a medical benefit following a motor vehicle accident.

The Tribunal found that the insurer failed to provide a compliant denial notice for the non-earner benefit until November 26, 2016, and ordered payment of the benefit from the end of the 26-week deductible period until that date.

However, the Tribunal dismissed the claim for ongoing non-earner benefits, finding the applicant did not suffer a complete inability to carry on a normal life.

The claim for a medical benefit was also dismissed as the proposed treatment was not reasonable and necessary, given the applicant's extensive pre-existing back issues.

A claim for a special award under O. Reg 664 was dismissed.

The applicant, who was five years old at the time, was injured when a car crashed into her daycare in 2009.

Seven years later, she sought payment for chiropractic, massage, and psychological treatments, as well as a cognitive assessment, attributing her back pain and psychological symptoms to the accident.

The respondent insurer denied the benefits, arguing she had reached maximum medical recovery.

The Licence Appeal Tribunal dismissed the application, finding that the physical injuries had resolved shortly after the accident and current back pain was due to poor posture.

The Tribunal also found the proposed psychological treatment and cognitive assessment were not reasonable and necessary given the mildness of the symptoms and the applicant's reluctance to participate.

The applicant sought statutory accident benefits following a motor vehicle accident, including medical benefits, housekeeping expenses, and a special award.

Despite the applicant's failure to attend the hearing, his counsel proceeded.

The arbitrator dismissed the claims for medical benefits, preferring the evidence of the insurer's medical experts who conducted physical examinations over the applicant's expert who only performed a paper review.

The arbitrator also found that the treatment facility had overbilled for the duration of sessions.

The claims for housekeeping and a special award were dismissed due to lack of evidence and the finding that no benefits were unreasonably withheld.

The insurer was awarded its arbitration expenses.