6 total
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The central issue was whether the applicant's injuries fell outside the Minor Injury Guideline (MIG) due to pre-existing conditions or psychological injuries sustained in the accident.
The Tribunal found that the applicant failed to provide compelling evidence of a pre-existing condition that would prevent maximal recovery within the MIG.
Furthermore, the Tribunal preferred the evidence of the insurer's section 44 psychological examination over the applicant's self-reported pre-screening, concluding that the applicant did not suffer a psychological injury as a result of the accident.
As the applicant remained within the MIG, and failed to provide copies of the impugned treatment plans, the claims for medical benefits, interest, and a special award were dismissed.
Accident benefits application dismissed; injuries fell within Minor Injury Guideline due to symptom exaggeration.
The applicant sought statutory accident benefits following a rear-end motor vehicle collision.
The respondent denied claims for non-earner benefits and various medical, psychological, and physiotherapy treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant failed to prove a complete inability to carry on a normal life, noting she returned to full-time work and her self-reporting was inconsistent.
The Tribunal also held that the applicant's physical injuries fell within the MIG and rejected her claim of a psychological impairment, preferring the respondent's expert evidence which demonstrated significant symptom exaggeration and failed validity testing.
As the MIG limits were exhausted, the treatment plans and claim for interest were dismissed.
Functional ability evaluation and chronic pain assessment granted; other treatment plans denied for lack of objective evidence.
The applicant was injured in a motor vehicle accident and sought various medical benefits and assessments under the Statutory Accident Benefits Schedule.
The insurer denied the treatment plans.
The Tribunal found that the functional ability evaluation and chronic pain assessment were reasonable and necessary, given the applicant's consistent pain complaints and the persuasive report of a chronic pain specialist.
However, the claims for chiropractic treatment, a neuropsychological assessment, and an orthopaedic assessment were dismissed for lack of supporting objective medical evidence.
Application for statutory accident benefits dismissed; applicant failed to prove employment status and treatment necessity.
The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs) and various medical and rehabilitation benefits.
The Tribunal found that the applicant was not employed at the time of the accident and therefore did not qualify for IRBs.
The Tribunal also dismissed the claims for an orthopedic mattress, chiropractic treatment, and psychological treatment, finding that the impairments were either pre-existing or the treatments were not proven to be reasonable and necessary.
The application was dismissed in its entirety.
Applicant's psychological impairments removed him from the Minor Injury Guideline, entitling him to various medical assessments.
The applicant was injured in a motor vehicle accident and sought various statutory accident benefits that were denied by the respondent insurer on the basis that his injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant's injuries fell outside the MIG due to overwhelming evidence of a psychological impairment resulting from the accident.
Consequently, the Tribunal approved treatment and assessment plans for a physiatrist assessment, a neurological assessment, a psychological assessment, and psychological counselling sessions.
However, the Tribunal denied claims for attendant care benefits, an attendant care assessment, assistive devices, and further chiropractic treatments, finding that the applicant was largely independent in his activities of daily living and that facility-based physical therapy was no longer reasonable and necessary.
Threshold motion granted; plaintiff failed to prove permanent serious impairment.
The defendants brought a statutory “threshold motion” under s. 267.5 of the Insurance Act during a jury trial arising from a motor vehicle accident.
The issue was whether the plaintiff had sustained a permanent serious impairment of an important physical, mental, or psychological function sufficient to overcome the statutory bar to non‑pecuniary damages under Ontario’s auto insurance regime (Regulation 381/03, Bill 198).
The court assessed conflicting medical evidence regarding alleged chronic pain, spinal injury, and psychological impairment.
The court found the plaintiff lacked credibility, failed to comply with treatment recommendations, and that surveillance evidence undermined his reported limitations.
Preferring the defence orthopedic expert’s opinion that no objective pathology explained the complaints, the court held the plaintiff failed to meet the statutory threshold.