5 total
Applicant removed from Minor Injury Guideline due to psychological impairment and chronic pain syndrome; IRBs awarded.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits.
The insurer denied income replacement benefits, a medical benefit, and the cost of a psychological assessment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found that the applicant's injuries were not minor, as he suffered from a psychological impairment and chronic pain syndrome that could not be treated within the $3,500 MIG limit.
The Tribunal awarded income replacement benefits up to the 104-week mark, finding the applicant suffered a substantial inability to perform the essential tasks of his pre-accident employment.
The Tribunal also awarded the cost of a psychological assessment but denied the remaining balance for a physiotherapy treatment plan because the massage therapy rate exceeded the FSCO guideline limit.
Applicant removed from Minor Injury Guideline due to severe psychological impairment; psychological treatment plan approved.
The applicant was struck by a vehicle while crossing an intersection as a pedestrian.
She applied for accident benefits, but the respondent insurer denied treatment plans for psychological and physiotherapy services, arguing her injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant's severe major depressive disorder and situational phobia, as diagnosed by her psychologist, removed her from the MIG.
The Tribunal ordered payment for the psychological services as reasonable and necessary, but denied the physiotherapy services due to insufficient evidence supporting their necessity.
Appeal dismissed as abandoned after appellants' counsel failed to appear without adequate explanation or documentation.
The appellants' counsel failed to appear for the appeal hearing, with an assistant citing counsel's illness.
The Court of Appeal noted a lack of supporting medical documentation and expressed serious doubts about the veracity of counsel's position.
The court refused a request for an adjournment, dismissed the appeal as abandoned, and awarded costs to the respondents.
Application for accident benefits dismissed due to applicant's failure to attend the arbitration hearing.
The applicant sought statutory accident benefits following a motor vehicle accident.
After the applicant's representative was removed from the record, the applicant failed to attend the rescheduled arbitration hearing despite receiving notice.
The arbitrator dismissed the application for arbitration due to the applicant's failure to appear and present evidence.
The insurer was awarded $2,500 in expenses for preparation and attendance.
Insurer awarded $1,419.05 in expenses after successfully dismissing an accident benefits claim as time-barred.
The applicant's claim for statutory accident benefits was previously dismissed as time-barred.
In this decision on expenses, the insurer sought over $6,000 in costs.
The arbitrator found that while the insurer was successful and entitled to expenses, the amount claimed was disproportionate to the simple preliminary issue hearing.
Applying the Legal Aid Services Act tariff as a guideline, the arbitrator fixed the insurer's reasonable expenses at $1,419.05, payable by the applicant.