Joy Kohli

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a concussion assessment and a physiotherapy treatment program.

The respondent insurer denied the benefits based on an insurer's examination report.

The Tribunal found the applicant's medical evidence, including assessments from a psychologist, a chronic pain physician, and a concussion management physiotherapist, outweighed the respondent's general practitioner report, which lacked specific concussion testing.

The Tribunal ordered the respondent to pay for the disputed treatment plans and interest on overdue payments.

However, the Tribunal dismissed the applicant's claim for a special award, finding the respondent's reliance on its medical reports was not unreasonable or arbitrary.

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

The respondent denied benefits and scheduled insurer's examinations, which the applicant failed to attend.

The respondent argued the applicant was barred from proceeding with his application under s. 55(1)2 of the Schedule.

The Tribunal found that the respondent's notices of examination did not comply with s. 44(5) of the Schedule because they failed to provide specific details about the applicant's medical condition forming the basis of the decision.

As the notices were deficient, the applicant was not barred from proceeding with his application.

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

The applicant claimed entitlement to non-earner benefits and a psychological assessment.

The Licence Appeal Tribunal found that the applicant failed to provide sufficient medical evidence to prove her physical or psychological injuries warranted removal from the MIG.

The Tribunal preferred the respondent's psychological assessment, which found no significant impairment.

The claims for non-earner benefits, the treatment plan, interest, and an award were all dismissed.

The applicant, an international student, was injured in a motor vehicle accident and sought visitor's expenses for her mother's travel from China to Canada, claiming the visits were necessary for her recovery.

The respondent denied the benefits.

The Licence Appeal Tribunal found numerous inconsistencies in the applicant's evidence regarding her injuries, employment, and when she informed her family about the accident.

The Tribunal concluded that the applicant failed to prove on a balance of probabilities that the visitor's expenses were reasonable, necessary, or incurred as a result of the accident.

The application was dismissed.

The applicant sought reconsideration of a Licence Appeal Tribunal decision denying her claims for a psychological assessment and a special award.

The adjudicator granted the reconsideration in part, finding an error of law in the initial decision regarding the psychological assessment.

Because the insurer provided its denial outside the 10-day period required by s. 38(8) of the Statutory Accident Benefits Schedule, the treatment plan was automatically payable under s. 38(11) without the applicant needing to prove the services were incurred.

However, the adjudicator upheld the initial decision denying a special award, finding the applicant failed to demonstrate an error of law or fact that would have changed the result.

The applicant sought payment for a psychological assessment and a special award following a motor vehicle accident.

The adjudicator found that the psychological assessment was not reasonable and necessary, as the applicant's family physician records showed a scarcity of psychological complaints and the respondent's psychological assessor concluded she did not suffer from a formal psychological condition.

The adjudicator also dismissed the claim for a special award, finding that although the respondent was late in denying the treatment plan, its conduct did not warrant an award.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for various assessments and assistive devices.

The Licence Appeal Tribunal found that the applicant failed to prove the proposed neurological assessment, functional abilities evaluation, in-home ergonomic assessment, and assistive devices were reasonable and necessary.

The applicant's primary injury was a fractured forearm, which had largely resolved, and there was insufficient medical evidence to support the need for the disputed items.

The application was dismissed.