Dr. Lewis

The applicant sought statutory accident benefits following a motor vehicle accident, including attendant care benefits, medical and rehabilitation benefits, and the cost of various assessments.

The insurer denied the benefits.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to demonstrate that the claimed attendant care benefits were incurred or reasonable and necessary, given her self-reported independence with activities of daily living.

The Tribunal also found that the proposed psychological, chiropractic, and neurological assessments and treatments were not reasonable and necessary, preferring the evidence of the insurer's examiners.

As no benefits were payable, claims for interest and a special award were also dismissed.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, including a determination of catastrophic impairment.

The central issue was whether the accident caused the rapid progression of the applicant's pre-existing peripheral arterial disease, which ultimately required an above-the-knee amputation.

The Tribunal applied the 'but for' test and found that the applicant's accident-related lack of mobility was a necessary cause of the disease's progression and the resulting amputation, thereby meeting the criteria for catastrophic impairment.

The Tribunal also awarded non-earner benefits, partial attendant care benefits, costs for chiropractic treatment and catastrophic impairment assessments, and interest on overdue payments, while dismissing a claim for a home exercise program.

The applicant sought a medical benefit for physiotherapy in the amount of $1,899.96 following a motor vehicle accident.

The respondent denied the treatment plan, arguing the applicant's physical injuries were predominantly minor and the treatment was not reasonable and necessary.

The Tribunal found that the applicant failed to establish on a balance of probabilities that the treatment plan was reasonable and necessary, noting that the applicant reported only short-term relief from previous treatment.

The application was dismissed, and the respondent's claim for costs was also denied.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including non-earner benefits, medical/rehabilitation treatments, and various assessments.

The insurer denied many of the benefits based on reports from its assessors.

The Licence Appeal Tribunal found that the applicant met the test for a complete inability to carry on a normal life and awarded non-earner benefits for the 104-week post-accident period.

The Tribunal also approved the disputed treatment plans and assessments, subject to the $2,000 statutory cap per assessment.

Furthermore, the Tribunal ordered the insurer to pay interest on overdue benefits and a special award of 33% under O. Reg. 664, finding that the insurer unreasonably delayed approving treatments that its own experts had recommended.