Dr. Hastings

During a jury trial for a personal injury action arising from a motorcycle collision, the defendant brought a threshold motion under s. 267.5 of the Insurance Act.

The defendant sought a declaration that the plaintiff's claims for healthcare expenses and non-pecuniary losses were barred.

The court evaluated medical and lay evidence regarding the plaintiff's mild traumatic brain injury and post-concussion syndrome.

The court found that while the plaintiff could still work with accommodations, her impairments significantly disrupted her activities of daily living and social life.

The motion was dismissed, as the plaintiff established she sustained a permanent, serious impairment of an important physical, mental, or psychological function.

The applicant was involved in a motor vehicle accident and sought income replacement benefits (IRBs) beyond the 104-week mark.

The respondent insurer terminated the benefits, relying on surveillance evidence of the applicant playing video games for extended periods and an assessment suggesting he could work in sedentary roles.

The Tribunal found that the applicant suffered from a mild traumatic brain injury and lumbar radiculopathy, which completely impaired his ability to engage in suitable employment.

The Tribunal rejected the respondent's reliance on the video game surveillance, noting that gameplay does not equate to competitive employability in a real-world setting.

The applicant was awarded ongoing IRBs and interest, but his claim for a special award for unreasonable withholding of benefits was dismissed.

The applicant sought a determination that she sustained a catastrophic impairment (CAT) due to a mental or behavioural disorder following a 2017 motor vehicle accident, which she claimed aggravated pre-existing concussion symptoms from a 2014 work incident.

The Tribunal found that while the applicant suffers from somatic symptom disorder and functional limitations, her impairments in activities of daily living do not rise to the level of a marked (Class 4) impairment under the AMA Guides.

Consequently, she did not meet the criteria for CAT status.

As her non-CAT policy limits were exhausted, her claims for various medical and attendant care benefits were dismissed as moot.

The Tribunal awarded the applicant $2,000 in costs due to the respondent's excessive and unnecessary objections during the hearing.

The applicant was injured in a serious motor vehicle accident and sought a determination that he sustained a catastrophic impairment under s. 3.1(1)(7) of the Statutory Accident Benefits Schedule.

The applicant submitted his whole person impairment (WPI) rating was 60%, while the respondent insurer argued it was 34%.

The adjudicator evaluated competing expert medical evidence regarding the applicant's orthopaedic, neurological, and psychological impairments.

After assessing the ratings under the AMA Guides, the adjudicator concluded the applicant's total WPI was 46%.

As this fell below the 55% threshold, the application was dismissed.