Bevin Shores

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits (IRBs) and medical/rehabilitation benefits.

The Licence Appeal Tribunal found that the applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident employment as a caregiver, nor a complete inability to engage in any employment post-104 weeks, and thus denied the IRBs.

However, the Tribunal found the claimed treatment plans for chiropractic, massage, physiotherapy, and mental health therapy to be reasonable and necessary due to objective evidence of physical and psychological impairments caused by the accident.

The medical benefits and interest on overdue payments were awarded.

The applicant, who was deemed catastrophically impaired following a motor vehicle accident, sought payment for four physiotherapy treatment plans.

The insurer denied the claims on the basis that the applicant had reached maximal medical recovery for his musculoskeletal injuries.

The adjudicator preferred the evidence of the insurer's medical examiners, finding that the applicant's pain complaints had a strong non-organic component and that further physiotherapy would not be beneficial.

The adjudicator also found that the insurer's notices of denial were sufficient.

The application was dismissed.

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

The respondent insurer denied a treatment plan for physiotherapy, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered from chronic pain syndrome, which removed her from the MIG.

The Tribunal further determined that the proposed physiotherapy treatment plan was reasonable and necessary to provide temporary pain relief and improve function.

The applicant was awarded the $1,877.00 benefit and interest on overdue payments.

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

After her representative was removed from the record due to a breakdown in the solicitor-client relationship, the applicant failed to respond to communications or participate in the proceedings.

The insurer brought a motion to dismiss the application.

The arbitrator granted the motion under Rule 70.3 of the Dispute Resolution Practice Code, finding that the applicant's failure to pursue her claims diligently constituted a withdrawal.

The application was dismissed, and the insurer was awarded $1,521.30 in expenses.

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

After the applicant's representative withdrew as counsel of record due to an inability to locate the applicant, the insurer requested a dismissal of the arbitration application without a hearing.

The arbitrator dismissed the arbitration due to the applicant's non-participation and ordered the applicant to pay the insurer's expenses in the amount of $2,983.97.

The arbitrator declined to award the insurer the return of its $3,000.00 assessment fee because there was insufficient evidence that the applicant failed to submit to an insurer examination or provide required materials.

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

After the respondent disappeared, his counsel moved to be removed as representative of record.

The arbitrator allowed the withdrawal without terms and declined to deem the arbitration withdrawn.

The insurer appealed, seeking to hold the former counsel liable for legal expenses and to deem the arbitration withdrawn.

The Director's Delegate rejected the appeal regarding the withdrawal of the arbitration as premature, but accepted the appeal regarding the former counsel's withdrawal and liability for expenses.

The insurer's request for a stay of the arbitrator's decision was denied.

The applicant's representative brought a motion to be removed from the record due to a breakdown in the solicitor-client relationship, having lost contact with the applicant.

The insurer opposed the motion without terms, seeking its costs of $4,900 to be paid personally by the representative firm and requesting the arbitration be deemed withdrawn.

The arbitrator granted the representative's motion to withdraw, finding a fundamental breakdown in communication.

The arbitrator declined to order costs against the representative personally, finding the representative had authority to commence the proceeding to preserve the applicant's rights and was acting in the usual course of the practice of law under s. 282(11.3) of the Insurance Act.

The arbitrator also declined to deem the arbitration withdrawn, as the applicant did not have proper notice of that request.