Kim Teggelove

The 92-year-old appellant suffered catastrophic injuries in a motor vehicle accident and sought statutory accident benefits to modify her daughter's home, where she intended to move to receive 24-hour care.

The Licence Appeal Tribunal denied the claim, holding that the appellant first had to prove her existing condominium could not be modified.

On appeal, the Divisional Court found the LAT erred in law by imposing an unlegislated threshold and adopting an unduly narrow interpretation of 'existing home' under section 16 of the SABS.

The appeal was allowed, and the insurer was ordered to pay the claimed benefits immediately.

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

The respondent denied treatment plans for an electric bed and various occupational therapy devices, and attempted to argue the application was statute-barred due to the applicant's failure to attend an insurer's examination.

The Tribunal refused to hear the preliminary issue as it was not properly raised.

On the merits, the Tribunal found the electric bed, front entrance bench, carpet runner, grab bars, and body scrubber were reasonable and necessary due to the applicant's chronic left shoulder impairment and compromised balance.

The Tribunal denied the cost of bilateral railings for lack of a proper quote, and denied handheld shower heads as the applicant already had functional ones.

Interest was awarded on the overdue benefits.

The applicant sought statutory accident benefits following a 2013 motor vehicle accident, including a home modifications assessment, yoga therapy, medical cannabis, and various physical therapies.

The respondent insurer denied the treatment plans.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove the treatments were reasonable and necessary.

The Tribunal noted the home modification assessment exceeded statutory limits and lacked safety justification, the yoga therapy duplicated approved attendant care, the applicant derived no benefit from medical cannabis, and physical therapies were ineffective for her resolved physical injuries.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including non-earner, attendant care, and housekeeping benefits, which the insurer denied.

The arbitrator found significant credibility issues with the applicant's evidence, noting surveillance footage that contradicted his claimed limitations and medical assessments indicating symptom magnification.

The arbitrator concluded that the applicant's ongoing issues were likely related to pre-existing degenerative conditions rather than the accident.

Consequently, the applicant failed to prove a complete inability to carry on a normal life or a reasonable necessity for the claimed attendant care and housekeeping services.

All claims for benefits, a special award, and interest were dismissed.