Tracy Shaw

The applicant was injured in a motor vehicle accident and sought statutory accident benefits.

The insurer initially deemed her catastrophically impaired but later reversed its decision based on an addendum report.

The applicant disputed the denial of several treatment plans submitted during the period she was deemed catastrophically impaired.

The Licence Appeal Tribunal held that the insurer could not retroactively apply its decision to revoke the catastrophic impairment designation, as the Schedule is consumer protection legislation.

The Tribunal found the applicant was entitled to apply for enhanced catastrophic policy coverage during that period.

The Tribunal partially approved two psychological treatment plans and two physical therapy treatment plans, finding them reasonable and necessary, but denied the remaining treatment plans and the request for an award.

The applicant filed a Request for Reconsideration of a previous Tribunal decision that denied a retroactive Form 1 for attendant care benefits, 24/7 supervisory care, and applied the 2010 Schedule's definition of 'incurred' expenses and interest rate.

The applicant argued the Tribunal made errors of law and fact and breached procedural fairness.

The Adjudicator dismissed the request, finding no error of law regarding the retroactive Form 1, as the applicant failed to provide evidence of urgency or impracticability.

The Adjudicator also found no error in applying the 2010 Schedule's definition of 'incurred' and interest rate, citing section 268(1) of the Insurance Act.

Finally, the Adjudicator concluded there was no misapprehension of evidence regarding the applicant's need for supervisory care, as the original decision properly weighed the testimony of multiple witnesses.