Jonathan B. White

The appellant sought judicial review and appealed a Licence Appeal Tribunal decision finding that her application for statutory accident benefits was time-barred.

The appellant argued the insurer's notice of refusal did not comply with s. 54 of the SABS because it failed to detail all levels of appeal and misleadingly stated a hard two-year limitation period without explaining discoverability.

The Divisional Court dismissed the appeal, holding that s. 54 only requires notice of the right to dispute the refusal at the Tribunal, not subsequent appeal rights.

The Court also found the notice was not misleading, as detailing discoverability principles could detract from the clarity of the warning and confuse claimants.

The applicant sought statutory accident benefits for chiropractic treatment following a motor vehicle accident.

The respondent insurer denied the treatment plan, relying on an insurer examination which concluded the applicant's shoulder instability was not accident-related.

The Tribunal dismissed the application, finding the applicant failed to submit evidence or arguments demonstrating the treatment was reasonable and necessary, and lacked jurisdiction to award a requested lump sum for future medical benefits.

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

The insurer partially denied an OCF-18 for catastrophic assessments and issued an Explanation of Benefits.

The applicant filed an application with the Licence Appeal Tribunal more than two years after the denial.

At a preliminary issue hearing, the applicant argued the limitation period was not triggered because the denial notice did not detail the entire dispute resolution process up to the Supreme Court of Canada or address discoverability.

The Tribunal rejected this argument, finding the denial notice was compliant with section 54 of the Schedule and the principles in Smith v. Co-operators, as it provided sufficient information for the applicant to decide whether to dispute the refusal.

As the applicant provided no submissions for an extension under section 7 of the LAT Act, the application was dismissed as statute-barred.

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

The Tribunal first dismissed the insurer's preliminary motion to bar the application for non-attendance at an insurer's examination, finding the request was made years after the application was filed.

On the substantive issues, the Tribunal found the applicant entitled to income replacement benefits for the pre-104-week period due to psychological impairments, but not for the post-104-week period as she did not suffer a complete inability to work.

The Tribunal also approved several treatment plans for occupational therapy, chiropractic, physiotherapy, and massage services, finding them reasonable and necessary.

Claims for a social work treatment plan balance and a special award were dismissed.

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

The respondent denied the benefits and raised a preliminary issue that the applicant failed to notify them of his intention to claim benefits within seven days of the accident, as required by section 32(1) of the Schedule.

The applicant notified the respondent approximately six months after the accident and provided no explanation for the delay.

The adjudicator found that the applicant failed to establish a reasonable explanation for the delay under section 34.

Consequently, the applicant is statute-barred from proceeding with his application pursuant to section 55(1)1 of the Schedule, and the application was dismissed.

The applicant sought entitlement to income replacement benefits, various medical benefits, interest, and an award under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application in its entirety.

The adjudicator found the applicant did not qualify for income replacement benefits as she was not employed for 26 of the 52 weeks prior to the accident and was receiving the Canadian Emergency Response Benefit, not Employment Insurance.

The claims for a chronic pain assessment, psychological treatment, and chiropractic treatment were denied as the applicant failed to demonstrate they were reasonable and necessary, with the adjudicator preferring the respondent's medical evidence.

The applicant sought statutory accident benefits following a motor vehicle accident but failed to submit a completed application and disability certificate within the prescribed timelines.

The respondent argued the application was statute-barred.

The Tribunal found that while the applicant's evidence of mental health issues and homelessness was credible, it did not amount to a reasonable explanation for the delay, as the respondent was prejudiced by the inability to assess the claim contemporaneously and the applicant failed to attend an Examination Under Oath.

The application was dismissed as statute-barred.

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

She failed to notify the insurer of her intention to apply within 7 days and did not submit a completed application within 30 days, waiting 21 months to apply.

The applicant argued that mental illness, homelessness, and a priority dispute provided a reasonable explanation for the delay under s. 34 of the Schedule.

The Tribunal found the applicant's evidence, consisting of limited clinical notes and emails, insufficient to establish a credible and reasonable explanation.

The application was barred from proceeding and dismissed.

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

The respondent insurer determined the injuries were minor and subject to the $3,500 Minor Injury Guideline (MIG) limit.

The applicant applied to the Licence Appeal Tribunal claiming chronic pain and psychological impairments warranted removal from the MIG, and sought a non-earner benefit (NEB), treatment plans, and expenses.

The Tribunal found the applicant's injuries were predominantly minor, noting a lack of medical evidence supporting chronic pain or psychological impairment, and that the applicant failed to attend insurer examinations because he was in China.

The Tribunal also dismissed the NEB claim as the applicant failed to demonstrate a complete inability to carry on a normal life.

The application was dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied her attendant care benefits on the basis that she failed to prove her care provider sustained an economic loss.

The applicant argued that the Tribunal erred in its calculation of the care provider's pre-accident earnings by excluding a specific pay period that included holiday pay.

The Vice-Chair dismissed the request, finding that the Tribunal had properly excluded the pay period because it represented abnormally high earnings and distorted the average, and that the applicant was attempting to relitigate the matter without establishing any error of fact or law.

The applicant was injured in a motor vehicle accident when struck as a pedestrian and sought attendant care benefits from the respondent insurer.

The respondent denied the claim, and the applicant applied to the Licence Appeal Tribunal.

The Tribunal found that the applicant failed to prove on a balance of probabilities that her non-professional care provider (her spouse) sustained an economic loss as a result of providing attendant care.

The evidence showed no marked difference between the care provider's pre- and post-accident hours of work and earnings.

The application for attendant care benefits, interest, and an award under Regulation 664 was dismissed.