Jessica L.J. Rogers

The applicant was involved in a motor vehicle accident and sought medical benefits and the cost of examinations from the respondent insurer.

The respondent denied the benefits on the basis that the applicant's injuries were predominantly minor and subject to the $3,500 Minor Injury Guideline (MIG) funding cap.

The applicant argued that his neck injuries and headaches warranted removal from the MIG.

The Tribunal found that the applicant failed to establish a causal link between the accident and the findings on a neck MRI conducted three years later.

The Tribunal also found that the applicant's headaches were clinically associated sequelae of his minor sprain and strain injuries.

As the applicant failed to prove his injuries fell outside the MIG, and the disputed benefits exceeded the funding cap, the application was dismissed.

The applicant's son was catastrophically injured in a motor vehicle accident, requiring 24-hour attendant care.

The applicant provided this care and received $6,000 monthly from her son's attendant care benefit.

The insurer reduced the applicant's income replacement benefit to zero, arguing the attendant care payments constituted post-accident income from self-employment under section 7(3) of the Statutory Accident Benefits Schedule.

The arbitrator found that the applicant was not engaged in a business and did not provide care with a view to profit.

The payments were not considered income from self-employment.

The insurer was ordered to pay the withheld benefits with interest, but no special award was granted as the insurer's position was not unreasonable.

The applicant was injured in a motor vehicle accident and claimed attendant care benefits for services provided by his spouse, a stay-at-home parent.

The insurer denied the claim because the spouse did not sustain an economic loss.

The arbitrator held that under the 2010 Statutory Accident Benefits Schedule, a family member providing care must either sustain an economic loss or provide the services in the course of their employment, occupation, or profession.

A stay-at-home parent does not meet the definition of providing care in the course of an occupation.

The application for attendant care benefits was dismissed.

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

After disputes arose, he applied for arbitration but subsequently lost contact with his counsel and failed to attend two pre-hearings and the arbitration hearing.

The arbitrator dismissed the application for arbitration due to the applicant's failure to attend and failure to provide evidence to support his claims.

The insurer was awarded $1,600 in expenses.