Jonathan Charland

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

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant was barred from disputing one treatment plan because he missed the two-year limitation period and the respondent's denial notice was valid.

On the substantive issues, the Tribunal held that the applicant's physical and psychological injuries were predominantly minor, keeping him within the MIG.

The Tribunal also dismissed the claim for a non-earner benefit, finding the applicant returned to work and failed to establish a complete inability to carry on a normal life.

Claims for an award and interest were also dismissed.

The Applicant sought entitlement to various treatment plans and an award under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The Respondent denied the plans and sought repayment of $12,800 in income replacement benefits, alleging the Applicant wilfully misrepresented her post-accident employment status.

The Tribunal dismissed the Applicant's claims, finding she failed to meet her burden to establish the reasonableness and necessity of the treatment plans or justify higher hourly rates.

The Tribunal granted the Respondent's request for repayment, holding that the Applicant's failure to respond to a section 33 request regarding her return to work constituted wilful misrepresentation, thereby exempting the Respondent from the standard 12-month notice period for repayment.

The applicant sought statutory accident benefits following a motor vehicle accident, including attendant care benefits, chiropractic treatment, and psychological services.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the proposed treatments and attendant care were reasonable and necessary.

The Tribunal also found no basis for an award for unreasonable delay or interest, as no benefits were overdue.

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

The applicant claimed entitlement to income replacement benefits (IRBs), various treatment plans, an IRB report, and an award for unreasonable delay.

The Tribunal found that the applicant's physical and psychological injuries were predominantly minor and did not warrant removal from the MIG, dismissing the claims for treatment plans beyond the $3,500 limit.

The Tribunal also dismissed the claim for IRBs, finding insufficient medical evidence to prove a substantial inability to perform essential employment tasks.

However, the Tribunal ordered the respondent to pay $2,034.00 for an IRB report, finding it reasonable and necessary to calculate the quantum of the claimed benefit, along with applicable interest.

The claim for an award was dismissed.

The applicant sought payment for the unapproved balances of two treatment plans for psychological services following a motor vehicle accident.

The Tribunal found that the applicant failed to prove the reasonableness and necessity of the higher hourly rate for a social worker under the first plan, and failed to provide evidence justifying a psychologist follow-up fee in the second plan.

The Tribunal also found the insurer's denial complied with section 38(8) of the Schedule.

The application was dismissed, with no entitlement to interest or an award.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and various medical benefits.

The Licence Appeal Tribunal found that the applicant was barred from pursuing the non-earner benefit because she failed to submit an Election of Income Replacement Form (OCF-10) as required by section 35(1) of the Schedule.

The Tribunal also dismissed the claims for medical benefits, including a SPECT scan, physiotherapy, cognitive training, and an attendant care assessment, finding that the applicant failed to prove they were reasonable and necessary.

The application was dismissed in its entirety.

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

The insurer raised a preliminary issue that the applicant was barred from proceeding because he failed to dispute the denial of benefits within the two-year limitation period under s. 56 of the Schedule.

The Tribunal found that the insurer failed to prove how the denial letters for the medical benefits were delivered, meaning the limitation period had not started for those claims.

However, the Tribunal found that a valid denial for Non-Earner Benefits was properly delivered to the applicant's legal representative, and the applicant failed to dispute it within two years or establish grounds for an extension under s. 7 of the LAT Act.

The applicant was permitted to proceed with the medical benefits claims but barred from pursuing the Non-Earner Benefits.

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

The insurer denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The applicant argued she should be removed from the MIG due to psychological impairment, pre-existing conditions, and chronic pain.

The Tribunal found insufficient objective medical evidence to support removal from the MIG, noting a lack of psychological complaints to her family doctor for over two years post-accident and placing greater weight on the insurer's psychological assessment which included validity testing.

As the MIG limit was exhausted, the treatment plans were not payable and the application was dismissed.

The applicant sought medical benefits for physiotherapy services following a minor rear-end motor vehicle accident.

The insurer denied the treatment plans.

The adjudicator found that the applicant had reached maximal medical recovery and that the proposed treatment plans were not reasonable and necessary, relying on the insurer's examination and the lack of objective evidence of ongoing impairment.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident while working as an Uber driver.

The insurer denied benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that he was not entitled to an income replacement benefit (IRB).

The Tribunal found that the applicant's physical injuries were predominantly minor and that he failed to prove a psychological impairment, noting inconsistencies in his self-reporting and surveillance video showing him performing various physical tasks.

The Tribunal also dismissed the claim for IRBs, finding no medical evidence that the applicant suffered a substantial inability to perform the essential tasks of his employment.

As the MIG limits were exhausted, the claims for further treatment plans and assessments were dismissed.

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

The respondent raised a preliminary issue that the applicant was barred from proceeding with his claims for non-earner benefits and a chronic pain assessment because he failed to attend multiple insurer's examinations (IEs).

The Tribunal found that the applicant failed to attend the scheduled IEs without a reasonable excuse and that the respondent was prejudiced by the non-attendance.

The Tribunal declined to exercise its discretion to allow the hearing to proceed.

The applicant's claims were barred, and he withdrew the remaining issues, resulting in the closure of the file.

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

The respondent denied medical and rehabilitation benefits, arguing the injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found the applicant sustained a psychological impairment (Adjustment Disorder) that removed him from the MIG.

The Tribunal awarded the costs of a psychological assessment, psychological treatment, and physiotherapy.

The applicant was also awarded income replacement benefits for a limited period, the cost of an accountant's report to calculate self-employment income, and interest.

The claim for a special award under s. 10 of Regulation 664 was dismissed as the insurer's conduct was not unreasonable.

The applicant sought a non-earner benefit of $185 per week following a motor vehicle accident, along with interest and costs.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to submit a completed disability certificate (OCF-3) supporting his entitlement, as required by section 36 of the Statutory Accident Benefits Schedule.

Furthermore, the Tribunal held that the applicant failed to prove on a balance of probabilities that his accident-related impairments continuously prevented him from engaging in substantially all of his pre-accident activities.

The applicant sought resolution of a dispute regarding the hourly rate at which Attendant Care Benefits (ACB) would be paid, despite the insurer having approved the submitted Form 1s in full.

The insurer raised a preliminary issue arguing the Licence Appeal Tribunal lacked jurisdiction under s. 280 of the Insurance Act because there was no live dispute over entitlement or the amount of the benefit.

The Tribunal agreed, finding that since the insurer approved the ACB in full and there was no denial, there was no dispute within the meaning of s. 280.

The application was dismissed for lack of jurisdiction.

The respondent insurer brought a motion to bar the applicant from proceeding with a claim for a non-earner benefit because the applicant failed to submit an OCF-10 form electing benefits.

The Licence Appeal Tribunal found that the applicant's OCF-3 indicated potential entitlement to both an income replacement benefit and a non-earner benefit, triggering the mandatory election requirement under section 35(1) of the Schedule.

Because the applicant failed to submit the requested OCF-10, the application was incomplete and the insurer was relieved from paying the benefit under section 33(6).

The applicant was barred from proceeding with the non-earner benefit claim, but the respondent's request for costs was dismissed.

The respondent insurer requested a reconsideration of a preliminary decision which found that the applicant's dispute for income replacement benefits was not statute-barred.

The Tribunal originally held that the limitation period did not begin until the denial notice was delivered to the applicant's counsel.

On reconsideration, the Vice-Chair found this to be an error of law, as section 64 of the Schedule does not require re-delivery of a valid notice to counsel retained after the initial delivery.

The reconsideration was granted, and the applicant's claim was found to be statute-barred.

The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits and medical benefits for physiotherapy.

The insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant's physical impairments were sprain and strain-type injuries falling within the MIG, and she failed to provide sufficient medical evidence of chronic pain or psychological impairment to warrant removal.

As the MIG limits were exhausted, the treatment plans were deemed not reasonable and necessary.

The Tribunal also dismissed the claim for non-earner benefits, finding the applicant failed to demonstrate a complete inability to carry on a normal life.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and medical benefits for physiotherapy.

The insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guidelines.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to provide any supporting documentary evidence or analysis to demonstrate entitlement to the disputed benefits.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the respondent insurer.

The insurer denied the disputed medical benefits on the basis that the applicant's injuries were predominantly minor and subject to the Minor Injury Guideline (MIG) limit.

The applicant argued that his injuries warranted removal from the MIG due to a pre-existing spine condition and chronic pain.

The Tribunal found that the applicant failed to establish that his pre-existing condition prevented his recovery under the MIG or that he suffered from accident-related chronic pain resulting in functional impairment.

As the MIG limit had not been exhausted, the applicant was entitled to seek treatment up to the limit, with interest payable on any outstanding payments for approved treatment.

The applicant was injured in a motor vehicle accident and sought income replacement benefits, which the respondent insurer denied.

The respondent raised a preliminary issue that the applicant's dispute was statute-barred under section 56 of the Statutory Accident Benefits Schedule.

The Tribunal found that the two-year limitation period did not begin to run until the respondent properly delivered the denial notice to the applicant's counsel under section 64, which occurred years after the initial denial.

The preliminary issue was dismissed, allowing the applicant's claim to proceed.