Mr. Danny Monck

The applicant sought various medical benefits, including a psychological assessment, functional abilities evaluation, vocational assessment, and labour market survey, following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant failed to prove the assessments were reasonable and necessary pursuant to the Statutory Accident Benefits Schedule.

The Tribunal noted that the applicant failed to provide specific submissions for the assessments and that the respondent's evidence, including comprehensive reports, demonstrated the assessments were either duplicative or unnecessary.

The application was dismissed, and claims for an award, interest, and costs were denied.

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident.

The respondent insurer suspended the IRBs after the applicant failed to attend a scheduled orthopaedic insurer's examination (IE).

The applicant argued the IE was not reasonably necessary and sought payment of the withheld IRBs, an award, and interest.

The Tribunal found that the requested orthopaedic IE was reasonably necessary given new medical evidence (an MRI showing an annular tear) and that the applicant failed to provide a reasonable explanation for his non-attendance.

Consequently, the insurer was not required to pay IRBs for the period of non-compliance.

However, the Tribunal awarded the applicant $250 in costs due to the insurer's unreasonable and bad faith conduct in evading service of a summons for its adjuster.

The insurer's request for costs was denied.