10 total
Applicant found catastrophically impaired under criterion 8 and awarded partial attendant care benefits.
The applicant was involved in a motor vehicle accident and sought statutory accident benefits, including a determination of catastrophic impairment under criterion 8 (mental and behavioural impairments).
The Licence Appeal Tribunal found that the applicant suffered a marked impairment in three spheres of functioning (Activities of Daily Living, Social Functioning, and Adaptation) and was therefore catastrophically impaired.
The Tribunal awarded attendant care benefits of $3,233.31 per month but dismissed the applicant's claims for various treatment plans, assessments, and a special award, finding insufficient evidence to support those claims.
Application for attendant care benefits and an orthopaedic mattress dismissed for lack of evidence.
The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming attendant care benefits and the cost of an orthopaedic mattress.
The Licence Appeal Tribunal dismissed the application, finding no evidence that the attendant care expenses were incurred and concluding that the orthopaedic mattress was not proven to be reasonable and necessary.
The Tribunal preferred the evidence of the respondent's orthopaedic surgeon over the applicant's occupational therapist regarding the necessity of the mattress.
Home modification benefit denied as proposed residence was not the applicant's existing home.
The applicant, who suffered a catastrophic impairment including a leg amputation in a motor vehicle accident, sought $607,445 for home modifications to his mother's residence.
The insurer denied the benefit.
The Licence Appeal Tribunal found that the mother's residence did not qualify as the applicant's "existing home" under s. 16 of the Schedule, as evidence showed he lived with his stepfather prior to the accident.
Furthermore, the Tribunal held there is no authority under the Schedule to redirect home modification funds into a trust for a future home purchase.
The Tribunal also dismissed the insurer's preliminary motion to dismiss the application for the applicant's failure to attend an Examination Under Oath, noting the Schedule does not prescribe dismissal as a penalty for such non-compliance.
The claims for an award and interest were dismissed.
Application for catastrophic impairment and accident benefits dismissed as applicant failed to meet impairment thresholds.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment under Criteria 6 and 7 of the Schedule.
The Tribunal found the applicant did not meet the 55% whole person impairment threshold, preferring the respondent's medical experts who assessed a 25% combined impairment over the applicant's experts whose ratings were unsupported by the AMA Guides.
The Tribunal also dismissed claims for income replacement benefits, attendant care benefits, and various treatment plans due to a lack of supporting evidence.
The respondent's claim for repayment of income replacement benefits was also dismissed for lack of evidence.
Application for accident benefits dismissed due to applicant's failure to provide supporting evidence in hearing brief.
The applicant sought statutory accident benefits following a 2013 motor vehicle accident, claiming entitlement to attendant care benefits, incurred attendant care expenses, various medical and rehabilitation benefits, and an award for unreasonable delay.
The Licence Appeal Tribunal dismissed the application in its entirety.
The Tribunal found that the applicant failed to meet her evidentiary burden, largely due to significant discrepancies between her written submissions and her hearing brief, which omitted crucial evidence.
The applicant failed to prove that the proposed attendant care and medical benefits were reasonable and necessary, or that the claimed expenses were incurred.
Application for accident benefits dismissed due to severe evidentiary deficiencies and failure to meet onus.
The applicant sought various statutory accident benefits, including attendant care benefits, medical benefits, and assessments, following a 2013 motor vehicle accident.
The Licence Appeal Tribunal held a written hearing to resolve the disputes.
The Tribunal dismissed the application in its entirety, finding that the applicant's case was significantly hampered by discrepancies between her written submissions and her hearing brief, including missing evidence and failure to pinpoint relevant documents.
The applicant failed to meet her onus to prove entitlement to attendant care benefits, incurred expenses, or the reasonableness and necessity of the proposed treatment and assessment plans.
Claims for interest and a special award were also dismissed.
A father's motion to vary interim support was dismissed for failing the four-part test.
The father (A.N.) brought a long motion seeking to retrospectively vary a temporary order from November 21, 2022, which required him to pay $5,134.24 per month for matrimonial home expenses and the mother's car payments, to $1,000.00 per month, citing health reasons and inability to work.
The mother (D.N.) opposed the motion.
The court dismissed the father's motion, finding he failed to satisfy the four-part test to vary a temporary order on an interim basis, specifically lacking "clean hands" a strong prima facie case, urgency, or hardship.
The court noted significant credibility issues with the father's claims of inability to pay and the mother's alleged hidden income, concluding these issues require a full trial.
Applicant denied catastrophic impairment status and most accident benefits, but awarded cost of assistive devices.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment, income replacement benefits, and various medical and assessment costs.
The Licence Appeal Tribunal found that the applicant did not meet the threshold for catastrophic impairment under either Criterion 7 (55% whole person impairment) or Criterion 8 (marked impairment in three spheres of functioning), preferring the evidence of the respondent's assessors.
The Tribunal also dismissed the claims for income replacement benefits, an accounting report, catastrophic assessment costs, and social worker treatment, finding them either unsupported by evidence or exceeding allowable rates.
The applicant was precluded from disputing a treatment plan due to failing to attend an insurer examination.
However, the Tribunal granted the cost of assistive devices, finding them reasonable and necessary to help the applicant with housekeeping tasks.
Claims for attendant care and treatment plans dismissed; IRB entitlement granted but reduced to zero.
The applicant sought statutory accident benefits following a motor vehicle accident, including attendant care benefits, income replacement benefits (IRBs), and a treatment plan for chiropractic and physiotherapy services.
The Licence Appeal Tribunal dismissed the claim for attendant care benefits because the applicant failed to prove the expenses were incurred and failed to comply with the insurer's requests for information under s. 33 of the Schedule.
The Tribunal found the applicant was entitled to IRBs for a closed period, but after deducting post-accident employment income (including Employment Insurance benefits), the payable amount was reduced to zero.
The claim for the treatment plan was dismissed as the applicant failed to establish it was reasonable and necessary, given a 19-month gap in treatment and lack of corroborating medical evidence.
Applicant denied attendant care and non-earner benefits but awarded costs for chronic pain and attendant care assessments.
The applicant sought payment for statutory accident benefits following a motor vehicle accident, including attendant care benefits, a non-earner benefit, and the cost of various assessments.
The Licence Appeal Tribunal found the applicant was not entitled to attendant care benefits or a non-earner benefit, as she failed to prove the expenses were reasonable and necessary or that she suffered a complete inability to carry on a normal life.
However, the Tribunal ordered the respondent to pay for a chronic pain assessment and two Assessments of Attendant Care Needs, finding them to be reasonable and necessary expenses, along with applicable interest.