Kamil Podleszanski

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found she was not removed from the Minor Injury Guideline and dismissed her claim for an income replacement benefit.

The applicant argued that new evidence, including catastrophic impairment reports, and errors in weighing expert psychiatric evidence warranted a reconsideration.

The Tribunal dismissed the request, finding the new evidence could have been obtained previously and that the applicant's arguments regarding the expert evidence amounted to a disagreement with the Tribunal's weighing of the evidence rather than an error of law or fact.

The applicant sought a special award under s. 10 of O. Reg. 664, alleging the respondent unreasonably delayed payment of an income replacement benefit (IRB).

The respondent argued the claim should be dismissed for procedural unfairness due to lack of particulars, which the Tribunal rejected.

The Tribunal found the respondent's conduct between February 29, 2024, and April 4, 2024, was excessive and imprudent, as the adjuster failed to actively review the file or address inconsistencies in the applicant's employment status until a complaint was lodged.

The Tribunal awarded the applicant $704.36, representing 50% of the IRB payable during the period of unreasonable delay, plus interest.

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 applicant claimed to have sustained a psychological injury that would remove him from the MIG.

The Tribunal found that the applicant did not prove on a balance of probabilities that he suffered from a psychological injury warranting removal from the MIG, preferring the respondent's psychological assessment over the applicant's.

As the applicant remained in the MIG, the disputed treatment plans and claim for interest were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit (IRB) and various medical benefits.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and she did not suffer a substantial inability to perform the essential tasks of her self-employment.

The Tribunal found the applicant failed to prove entitlement to an IRB, preferring the respondent's assessors who personally evaluated her over the applicant's paper-review assessor.

The Tribunal also concluded the applicant's physical, dental (TMJ), and psychological injuries did not warrant removal from the MIG.

The application was dismissed.

An appeal from an arbitration decision under the Insurance Act concerning priority of payment of statutory accident benefits.

The claimant, a 25-year-old who suffered severe traumatic brain injury in a motorcycle accident, was deemed catastrophically impaired.

The arbitrator determined that the claimant was principally dependent on his sister, who was insured by the appellant, rather than on his parents or the motorcycle insurer.

The appeal challenged the arbitrator's application of the dependency test, arguing that the arbitrator failed to properly apply all four criteria from the leading case and failed to conduct a precise calculation of the 51% threshold.

The court upheld the arbitrator's decision, finding no error of law or palpable and overriding error in the arbitrator's reasoning and factual conclusions.

The applicant sought payment for a catastrophic impairment assessment and an ENT assessment under the Statutory Accident Benefits Schedule.

The respondent denied the treatment plans.

The applicant argued the denials were non-compliant with s. 38(8) for failing to provide medical reasons.

The Tribunal found the denials were compliant as they were based on non-medical reasons (duplication of services and inclusive fees), applying the Court of Appeal's reasoning in Varriano.

The Tribunal further found the applicant failed to establish the assessments were reasonable and necessary.

The application was dismissed.

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

The matter proceeded to a written hearing, but the applicant failed to file any submissions or evidence.

The Tribunal proceeded in the applicant's absence pursuant to s. 7(2) of the Statutory Powers Procedure Act.

The Tribunal found that the applicant failed to meet her burden to demonstrate removal from the Minor Injury Guideline and entitlement to the disputed treatment plans, award, and interest.

The application was dismissed.

The applicant requested a reconsideration of a Tribunal decision which found he was not entitled to an income replacement benefit because he knew or ought reasonably to have known his motorcycle was uninsured.

The applicant argued the Tribunal erred in applying the contextual objective test and overlooked evidence that the MTO and dealership accepted his insurance certificate.

The Tribunal dismissed the request, finding the applicant was attempting to re-weigh the evidence and that no error of law or fact was made in the original decision.

The applicant requested a reconsideration of a decision finding his injuries fell within the Minor Injury Guideline and denying his treatment plans.

The applicant argued the Tribunal failed to consider arguments regarding sections 38, 44, and 64 of the Schedule.

The Tribunal dismissed the request, finding that while it may have erred in not fully outlining its analysis of section 38, the error would not have changed the outcome because the insurer provided proper notice of denial.

The Tribunal also found no errors regarding sections 44 and 64.

The applicant sought statutory accident benefits following a motorcycle accident.

The respondent insurer denied benefits, arguing the applicant was excluded under s. 31(1)(a)(i) of the Schedule for driving without valid insurance.

The applicant claimed he was a victim of fraud, having purchased what he believed was a valid policy from an unknown individual in a parking lot.

The Tribunal applied a contextual objective test and found that an ordinary rational person with the applicant's age, education, and prior experience purchasing insurance ought reasonably to have known the insurance card was fraudulent and the vehicle was uninsured.

The application for benefits was dismissed.

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

The respondent denied various treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to prove on a balance of probabilities that his physical or psychological injuries warranted removal from the MIG.

As the applicant had already exhausted the $3,500 MIG limit, the disputed treatment plans were not payable.

The application was dismissed.

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 applicant argued she should be removed from the MIG due to chronic pain, a concussion, and psychological impairments.

The Tribunal found insufficient medical evidence to establish that the applicant suffered from accident-related chronic pain resulting in functional impairment, a concussion, or a psychological impairment.

The Tribunal concluded the applicant's injuries were predominantly minor and subject to the $3,500 MIG limit.

As the applicant remained in the MIG and had exhausted most of the limit, the disputed treatment plans were not reasonable and necessary.

The Tribunal also denied the claim for incurred expenses because the applicant failed to submit treatment plans prior to incurring them, as required by section 38(2) of the Schedule.

The application was dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied his claims for an Income Replacement Benefit, an occupational therapy treatment plan, and an award under section 10 of Regulation 664.

The applicant argued that the Tribunal violated procedural fairness by providing inadequate reasons and relying on a sur-reply, and that it made errors of law and fact regarding the causation of his psychological impairments.

The Vice-Chair dismissed the request, finding that the original decision was well-reasoned, the applicant had failed to object to the sur-reply prior to the hearing, and the applicant was improperly attempting to re-litigate the Tribunal's assessment of the evidence.

The applicant was involved in a rear-end motor vehicle accident and sought statutory accident benefits, including income replacement benefits (IRBs) and various medical and rehabilitation benefits.

The respondent insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and its $3,500 funding limit.

The Tribunal found that the applicant sustained predominantly minor injuries (soft tissue sprains/strains) and failed to prove that pre-existing conditions, neurological issues, psychological injuries, or chronic pain warranted removal from the MIG.

The Tribunal also found the applicant failed to demonstrate a substantial inability to perform the essential tasks of his pre-accident employment, denying the claim for IRBs.

The application was dismissed in its entirety.

The applicant sought income replacement benefits and an occupational therapy treatment plan following a motor vehicle accident where his vehicle went into a canal.

The applicant claimed the accident exacerbated his pre-existing psychosis and caused physical injuries preventing him from working as a food delivery and ride-share driver.

The Tribunal found that the applicant's psychological symptoms were pre-existing and not caused or exacerbated by the accident.

The Tribunal also found that the applicant's physical injuries were minor strains that did not result in a substantial inability to perform the essential tasks of his employment.

The application was dismissed in its entirety.

The applicant sought a non-earner benefit, an award, interest, and costs following a motor vehicle accident.

The respondent denied the benefits, arguing that the applicant's inability to carry on a normal life was due to significant pre-existing physical and psychological conditions, not the accident.

The Tribunal found that the applicant failed to demonstrate a complete inability to carry on a normal life as a result of the accident, noting that his pre-accident conditions had already rendered him unable to work and limited his activities of daily living.

The Tribunal accepted the respondent's insurer's examination reports, which concluded the applicant could still engage in his pre-accident activities.

The claims for a non-earner benefit, an award, interest, and costs were dismissed.

The applicant was injured in a motor vehicle accident and sought payment for 11 treatment plans under the Statutory Accident Benefits Schedule.

The respondent insurer denied the plans as not reasonable and necessary.

The Licence Appeal Tribunal reviewed the medical evidence, including reports from various assessors and treating practitioners.

The Tribunal found that the applicant sustained a mild traumatic brain injury and granted the $7,808.97 treatment plan for occupational therapy, along with interest.

The remaining 10 treatment plans, including those for orthotics, case management, rock climbing therapy, medical cannabis, and various physical therapies, were dismissed for lack of supporting objective medical evidence.

The applicant requested a reconsideration of a Tribunal decision that found her psychological impairments fell within the Minor Injury Guideline (MIG).

The adjudicator determined that an error of law was made in the previous decision, as the applicant's psychological impairment was rooted in previously documented anxiety and was not a clinically associated sequelae of her minor injuries from the accident.

The reconsideration was granted, and the previous decision was varied to remove the applicant from the MIG.

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

The respondent insurer determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and its $3,500 funding limit.

The applicant argued that pre-existing shoulder and psychological issues, along with accident-related chronic pain and psychological impairment, removed him from the MIG.

The Tribunal found insufficient medical evidence to support the applicant's claims, noting inconsistencies between the applicant's self-reports, his family physician's records, and the insurer's examinations.

The Tribunal concluded the injuries were predominantly minor and subject to the MIG limit, which the respondent had already substantially paid.

The disputed treatment plans were therefore not payable.

The applicant sought medical benefits following a motor vehicle accident, arguing that psychological injuries should remove her from the Minor Injury Guideline (MIG).

The Tribunal preferred the applicant's expert evidence diagnosing an adjustment disorder and depressed mood, but found the impairment was on the less severe spectrum and did not cause a loss of functional abilities.

The Tribunal concluded the applicant's injuries were predominantly minor and she should remain subject to the MIG limit.

Claims for psychological services and assessments were denied, while chiropractic services were approved up to the $3,500 limit.