31 total
Application for accident benefits dismissed; applicant failed to prove entitlement to removal from MIG or NEB.
The applicant sought accident benefits following a motor vehicle accident, disputing the insurer's determination that his injuries fell within the Minor Injury Guideline (MIG).
The applicant argued for removal from the MIG based on chronic pain and psychological impairment, relying on an orthopedic assessment.
The Tribunal found the applicant did not meet the burden of proof, assigning more weight to the insurer's examinations which found normal physical limits and no functional impairment.
The Tribunal also dismissed the claim for a non-earner benefit, finding the applicant returned to school and managed job responsibilities, failing to demonstrate a complete inability to carry on a normal life.
The application was dismissed.
Application for accident benefits dismissed as impairments were caused by pre-existing degenerative disc disease.
The applicant sought statutory accident benefits following a 2020 motor vehicle accident, including income replacement benefits (IRBs), various treatment plans, and an award for unreasonable delay.
The respondent denied the benefits, arguing the applicant's impairments were due to pre-existing degenerative disc disease and a prior 2016 accident.
The Tribunal found the applicant failed to prove her impairments were caused by the subject accident, relying on the respondent's s. 44 assessors who concluded her physical and psychological complaints were not accident-related.
All claims for IRBs, treatment plans, assessments, interest, and an award were dismissed.
The respondent's request for costs was also dismissed.
Applicant's injuries found to be predominantly minor; claims for treatment plans beyond MIG limit dismissed.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued she should be removed from the MIG due to a psychological condition.
The Tribunal found the applicant's psychological evidence unreliable as it lacked validity testing and was based on self-reporting.
The Tribunal preferred the respondent's psychological assessment, which found symptom magnification and no psychological disorder.
The Tribunal concluded the applicant's injuries were predominantly minor and subject to the MIG limit, dismissing the claims for treatment plans and interest.
Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident, arguing her injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain and psychological impairments.
The Licence Appeal Tribunal found the applicant failed to meet her burden of proof.
The medical evidence, including clinical notes from her family physician, did not corroborate her claims of accident-related chronic pain or psychological injury.
The Tribunal preferred the respondent's insurer's examination reports, which concluded the applicant sustained only minor soft tissue injuries that had resolved.
As the applicant remained within the MIG, her claims for various treatment plans and interest were dismissed.
Application for accident benefits dismissed; applicant's injuries found to fall within the Minor Injury Guideline.
The applicant was injured in a motor vehicle accident and sought accident benefits, which the respondent insurer denied on the basis that her injuries fell within the Minor Injury Guideline (MIG).
The applicant applied to the Licence Appeal Tribunal, arguing she should be removed from the MIG due to psychological injuries and chronic pain.
The Tribunal found insufficient evidence of a psychological injury, preferring the respondent's psychological assessment over the applicant's, and noted a lack of contemporaneous medical evidence supporting chronic pain.
The Tribunal concluded the applicant's injuries were predominantly minor, subject to the MIG limit, and dismissed the claims for psychological treatment, assessment, and interest.
Application for accident benefits dismissed; treatment plans not proven reasonable and necessary.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to occupational therapy, chiropractic services, and a psychological assessment.
The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove on a balance of probabilities that the proposed treatment plans were reasonable and necessary.
The Tribunal noted a lack of compelling contemporaneous medical evidence supporting the physical treatments and found that the applicant's psychological complaints were largely related to pre-existing conditions and interpersonal stressors rather than the accident.
Application for accident benefits dismissed; injuries fell within the Minor Injury Guideline.
The respondent denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant's physical injuries were soft tissue in nature and that she failed to establish a psychological impairment that would remove her from the MIG.
Because the MIG limit was exhausted and the respondent's denial notices complied with the Schedule, the applicant was not entitled to the disputed treatment plans.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline limits.
The applicant sought accident benefits following a motor vehicle accident, arguing that chronic pain and psychological impairments warranted removal from the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found that the applicant failed to establish chronic pain with functional limitations or a psychological impairment, noting a lack of supporting contemporaneous medical evidence and relying on the respondent's section 44 assessment.
As the applicant's injuries were deemed predominantly minor and the $3,500 MIG limit had been exhausted, the claim for a $2,500 orthopedic assessment and interest was dismissed.
Application for accident benefits beyond the Minor Injury Guideline dismissed due to insufficient evidence.
The applicant sought statutory accident benefits following a motor vehicle accident, arguing her injuries warranted removal from the Minor Injury Guideline (MIG) due to psychological impairments and chronic pain.
The Licence Appeal Tribunal found that the applicant sustained predominantly minor soft tissue injuries.
The Tribunal preferred the respondent's insurer examination reports, finding insufficient evidence of a psychological impairment or chronic pain meeting the AMA Guides criteria.
The applicant's injuries were deemed subject to the $3,500 MIG limit, and the application for additional treatment plans was dismissed.
Applicant's injuries remained within the MIG, but defective denial notices rendered certain treatment plans payable.
The respondent denied several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The adjudicator found the applicant failed to establish chronic pain or psychological impairments warranting removal from the MIG, preferring the respondent's expert evidence.
However, the adjudicator ordered the respondent to pay for a chronic pain assessment and psychological treatment because the respondent's denial notices failed to comply with s. 38 of the Schedule by not explicitly stating that the MIG applied.
Claims for an award and costs were dismissed.
Accident benefits claims dismissed as applicant failed to prove injuries warranted removal from the Minor Injury Guideline.
The applicant was involved in two separate motor vehicle accidents and sought statutory accident benefits, which the respondent insurer denied on the basis that the injuries fell within the Minor Injury Guideline (MIG).
The applicant argued that his physical and psychological injuries, as well as pre-existing conditions, warranted removal from the MIG.
The Tribunal found that the applicant failed to provide persuasive medical evidence, such as diagnoses from qualified practitioners, to prove his injuries extended beyond the MIG definition.
The Tribunal preferred the evidence of the respondent's physiatrists, who concluded the injuries were soft tissue in nature and treatable within the MIG.
As the applicant had exhausted the MIG limits for both accidents, the claims for outstanding treatment plans and interest were dismissed.
Claim for income replacement benefits dismissed due to section 33 non-compliance and failure to meet disability test.
The applicant sought income replacement benefits (IRBs) following a motor vehicle accident.
The respondent denied the claim, arguing the applicant failed to comply with section 33 requests for information regarding a potential address misrepresentation, and alternatively, that the applicant did not meet the disability test.
The Tribunal found the applicant did not have a reasonable explanation for failing to provide most of the requested documents, justifying the respondent's withholding of benefits.
Substantively, relying on the respondent's insurer's examinations, the Tribunal concluded the applicant did not suffer a substantial inability to perform the essential tasks of his pre-accident employment as a cleaner.
The claims for IRBs, an award, interest, and costs were dismissed.
Application for income replacement benefits dismissed as applicant failed to prove substantial inability to work.
The respondent insurer denied the benefits after an insurer's examination found no residual physical impairments.
The Tribunal found that the applicant failed to prove on a balance of probabilities that she suffered a substantial inability to perform the essential tasks of her employment as a cashier.
The Tribunal relied on the objective findings of the respondent's physiatrist and noted the applicant had returned to work and travelled extensively post-accident.
The application for IRBs, a special award, and interest was dismissed.
Income replacement benefits denied due to conflicting evidence regarding the applicant's pre-accident employment tasks.
The applicant sought income replacement benefits and interest on overdue medical benefits following a motor vehicle accident.
The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered a substantial inability to perform the essential tasks of his pre-accident employment, as the evidence regarding his job duties was contradictory and unclear.
Consequently, the claim for income replacement benefits was dismissed.
However, the Tribunal ordered the respondent to pay interest on the previously resolved claims for a chronic pain assessment and physiotherapy, payable once those expenses were incurred.
Plaintiff's claim for general damages dismissed for failing to meet the statutory threshold for serious impairment.
Following a two-week jury trial for damages arising from a motor vehicle collision, the jury awarded the plaintiff $15,000 in general damages for a minor soft tissue strain.
The trial judge was required to determine whether the plaintiff met the statutory threshold under s. 267.5(5) of the Insurance Act.
The court found that while the plaintiff suffered a permanent impairment from a soft tissue injury to his left shoulder, the impairment was neither 'serious' nor 'important' as it did not substantially interfere with his employment or usual activities of daily living.
The plaintiff's claim for general damages was therefore dismissed.
Motion for occupational therapy assessment dismissed as unnecessary to meet the plaintiff's case.
The defendants brought a motion for an order requiring the plaintiff to attend a defence assessment with an occupational therapist.
The court noted a jurisdictional issue regarding whether a master has the inherent jurisdiction to order an examination by a non-health practitioner, but proceeded to hear the motion based on prior authority.
Applying the test from Ziebenhaus, the court found that the defendants already had a clear and unequivocal report from a physiatrist stating the plaintiff's injuries did not impact her ability to work or carry out normal activities.
The court concluded the requested assessment was merely to corroborate the existing report or obtain a matching report, which was insufficient.
The motion was dismissed.
Case allowed decision
The plaintiff was injured in a multi-car collision.
The defendants admitted liability, and the case proceeded to a jury for damages.
This ruling addresses a threshold motion brought by the plaintiff to determine if her claim for general damages is barred by s. 267.5(5) of the Insurance Act, which requires a "permanent serious impairment of an important physical, mental or psychological function." The court applied the three-part test from Meyer v. Bright and found that the plaintiff's impairments to her ability to work and attend school were permanent, important, and serious, thus meeting the statutory threshold.
Threshold motion granted; plaintiff failed to prove permanent impairment from motor vehicle accident.
Following a motor vehicle accident, the plaintiff sought damages for various physical and psychological injuries.
A jury awarded the plaintiff $10,000 in general damages and dismissed her other claims.
The defendants subsequently brought a threshold motion under section 267.5(5) of the Insurance Act.
The court held that the jury's verdict should be strongly considered when deciding a threshold motion.
Finding that the plaintiff's current conditions were not caused by the accident and agreeing with the jury's implicit finding of only minor and transitory injuries, the court granted the defendants' motion and dismissed the action.
Motion to dismiss 15-year-old action for delay denied; plaintiff ordered to attend audio-recorded defence medical examination.
The defendant moved to dismiss the plaintiff's 15-year-old personal injury action for delay and breach of court orders, primarily stemming from the plaintiff's failure to complete defence medical examinations.
The plaintiff, who had been self-represented for a significant period, refused to be examined by male doctors due to severe anxiety and later had conflicts with female examining doctors.
The court found the delay was inordinate but excusable given the circumstances, and that the defendant suffered no actual prejudice.
The motion to dismiss was denied, but the court ordered the plaintiff to attend a defence medical examination with a female specialist under strict conditions, including audio recording, warning that failure to comply would result in dismissal.
Motion to dismiss 15-year-old action for delay denied; strict terms imposed for audio-recorded defence medical examination.
The defendant moved to dismiss the plaintiff's 15-year-old personal injury action for delay and breach of court orders, primarily due to the plaintiff's failure to complete defence medical examinations.
The plaintiff, who had been self-represented for a significant period, refused to be examined by male doctors due to severe anxiety stemming from a past assault, and later had confrontational interactions with female examiners.
The Master found the delay was inordinate but excusable under the circumstances, and that the defendant suffered no actual prejudice.
The motion to dismiss was denied, but the Master imposed strict terms for a final defence medical examination, including that it be conducted by a female specialist and be audio recorded.