Kathryn McRae Hill

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

The insurer denied funding for physical therapy and a chronic pain assessment on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant sustained only minor soft tissue injuries and gave no weight to the applicant's expert reports diagnosing chronic pain and post-concussion syndrome due to outdated criteria and lack of qualifications.

The application was dismissed as the $3,500 MIG funding limit had been exhausted.

The applicant was injured in a motor vehicle accident and sought a medical benefit for psychological treatment.

The respondent partially approved the treatment plan but denied the remainder, disputing the hourly rate charged for a social worker providing the services.

The Tribunal found that the insurer was not required to pay above the Guideline rates and that the approved rate was reasonable, as there was insufficient evidence of the social worker's specialized training or private practice rates to justify the higher psychologist rate.

The application was dismissed.

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

The respondent denied a treatment plan for physiotherapy on the basis that the applicant's impairments fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to meet his burden of proving that his injuries warranted removal from the MIG, as he provided insufficient medical evidence of pre-existing conditions precluding recovery.

The Tribunal also found the treatment plan was not proven to be reasonable and necessary.

The application was dismissed.

The applicant sought interest on the cost of a chronic pain assessment following a motor vehicle accident.

The respondent insurer had initially denied the benefits but paid them prior to the hearing.

The sole issue was whether interest was owed due to late payment.

The Tribunal found that the applicant failed to provide evidence of when the invoice (OCF-21) was submitted to the insurer, which is required to trigger the 30-day payment period and subsequent interest obligations.

The claim for interest was dismissed.

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

During the arbitration hearing, the arbitrator reviewed correspondence regarding a prior adjournment request, which inadvertently disclosed a confidential settlement offer.

Citing a reasonable apprehension of bias, the arbitrator recused himself and adjourned the hearing to be heard by a different arbitrator, while remaining seized of the issue of expenses for the aborted hearing.