Gina Nardella

The applicant, a pedestrian struck by a motor vehicle, sought payment for a physiotherapy treatment plan under the Statutory Accident Benefits Schedule.

The respondent insurer denied the treatment plan, arguing the applicant had returned to a state of functional mobility.

The Licence Appeal Tribunal found the treatment plan reasonable and necessary to achieve the goals of increasing strength, reducing pain, and increasing range of motion.

The Tribunal ordered the respondent to pay the balance of the treatment plan with interest, and declined to award costs to either party.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that her injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that while the applicant's physical injuries were minor, her psychological impairments, including depression and anxiety, placed her outside the MIG.

The Tribunal denied five treatment plans for facility-based physical rehabilitation, finding the applicant had reached maximal recovery for her physical injuries.

However, the Tribunal approved the cost of a social work assessment up to the $2,000 statutory limit, finding it reasonable and necessary to address her ongoing psychological impairments.

Both parties' requests for costs were denied.

The Applicant sought statutory accident benefits following a motor vehicle accident.

A mediation was scheduled but the Applicant and her representative failed to attend without excuse.

The Insurer brought a motion to permanently stay the arbitration on the basis that the Applicant failed to participate in the mediation process, a statutory precondition to arbitration under the Insurance Act.

The Arbitrator agreed, finding that the Applicant's failure to attend meant the mediation did not take place, and therefore the statutory preconditions under sections 281(1) and (2) of the Insurance Act were not met.

The application for arbitration was permanently stayed.

The applicant sought medical benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent denied four treatment plans, arguing two were statute-barred and the applicant's injuries fell within the $3,500 Minor Injury Guideline (MIG) limit.

The Tribunal found the first treatment plan was statute-barred but the second was not.

While the applicant's injuries were predominantly minor, compelling evidence of a pre-existing degenerative disc disease demonstrated he could not achieve maximal recovery within the MIG limits.

However, the applicant failed to provide evidence or submissions proving the remaining treatment plans were reasonable and necessary, resulting in their dismissal.

No costs were awarded.

The applicant applied for arbitration regarding statutory accident benefits following a motor vehicle accident.

The applicant failed to attend the pre-hearing and the arbitration hearing.

The applicant's solicitor attended the hearing to request removal from the record, but the arbitrator denied the request because the applicant was not given proper notice.

As the applicant failed to attend and tender evidence to prove entitlement to the claimed benefits, the arbitration was dismissed.