Diana M. Oliveira

The applicant sought statutory accident benefits following a motor vehicle accident, claiming chronic pain and psychological injuries warranted removal from the Minor Injury Guideline (MIG).

The Tribunal excluded the applicant's family doctor's clinical notes and records due to an unexplained 175-day delay in service.

Without these records, the Tribunal found the applicant failed to meet the burden of proving non-minor injuries, as the remaining evidence from a chiropractor and occupational therapist could not diagnose psychological conditions.

The Tribunal concluded the applicant's injuries were predominantly minor, and dismissed the claims for treatment plans and interest.

The insurer requested a reconsideration of a Tribunal decision that awarded the insured interest on three treatment plans.

The insurer argued that it had complied with its obligations under section 38 of the Statutory Accident Benefits Schedule and had paid the treatment plans in full before the Tribunal application was filed.

The Tribunal agreed, finding that it had erred in law and fact by automatically applying section 51(4) to award interest.

The delay in the insurer's final determination was due to the insured's failure to attend scheduled assessments.

The reconsideration request was granted, and the order for interest was reversed.

The applicant sought non-earner benefits following a motor vehicle accident.

The insurer denied the benefits on the basis that the applicant was self-employed and working at the time of the accident.

The applicant filed an appeal to the Licence Appeal Tribunal more than eight months after the two-year limitation period expired.

The Tribunal found that the insurer's denial was clear and unequivocal, triggering the limitation period.

Applying the factors for an extension of time under section 7 of the Licence Appeal Tribunal Act, the Tribunal concluded that the applicant lacked a bona fide intention to appeal within the time limit, provided no reasonable explanation for the delay, and that the insurer would suffer prejudice.

The request to extend the limitation period was denied, and the appeal was dismissed as statute-barred.

The applicants requested a reconsideration of a Tribunal decision which found that the deceased's death was not caused by a motor vehicle accident.

The applicants argued that the Tribunal failed to consider the mental stress caused by the accident and exaggerated the deceased's pre-existing health conditions.

The adjudicator dismissed the request, finding that the Tribunal applied the correct legal test and properly relied on medical and coroner reports indicating that the death resulted from pre-existing medical issues and bleeding from a fall, rather than stress from the accident.

The applicant sought reconsideration of a preliminary issue decision that found his claim for income replacement benefits was statute-barred under s. 56 of the Schedule.

The applicant argued the Tribunal erred in its application of s. 56 and s. 7 of the LAT Act regarding an extension of time.

The Tribunal found no significant error of law or fact that would have changed the outcome, noting the 15-month delay was still significant.

The request for reconsideration was dismissed, as was the respondent's request for costs.

The applicant sought a death benefit under the Statutory Accident Benefits Schedule following the death of his father, who was involved in a minor rear-end motor vehicle accident and died eight days later.

The insurer denied the benefit on the basis that the death was not caused by the accident.

The Tribunal applied the 'but for' test for causation and found that the deceased's death was the result of pre-existing medical issues, including hypertension and a subsequent fall, rather than the accident.

The application was dismissed.

The applicant sought death benefits following the death of his father, who was involved in a minor rear-end motor vehicle accident and died eight days later.

The deceased had a pre-existing history of diabetes, hypertension, and heart issues, and suffered a fall at home days after the accident, leading to a brain bleed.

Applying the 'but for' test for causation, the adjudicator found that the accident did not cause the death.

The medical evidence, including a Coroner's report and a medical opinion, established that the death resulted from pre-existing medical issues and the subsequent fall, not the motor vehicle accident.

The application was dismissed.

The applicant sought death and funeral benefits after her husband died following a motor vehicle accident.

The husband was involved in a low-impact rear-end collision and was released from the hospital the same day.

Three days later, he fell, suffered a brain bleed, and subsequently died of a cardiac arrest.

The adjudicator applied the 'but for' test for causation and found that the death was caused by pre-existing medical issues and the subsequent fall, not the motor vehicle accident.

The application for benefits was dismissed.

The applicant sought income replacement benefits following a 2012 motor vehicle accident.

The insurer denied the claim in March 2015.

The applicant filed for mediation at FSCO in March 2016 but a mediation was never scheduled and no mediator's report was issued.

The applicant filed an application with the Licence Appeal Tribunal in May 2018, over two years after the denial.

The Tribunal held a preliminary issue hearing to determine if the claim was statute-barred.

The Tribunal found the claim was statute-barred under section 56 of the Schedule and declined to grant an extension of time under section 7 of the LAT Act, noting the significant delay and prejudice to the respondent.

The applicant sought death and funeral benefits following the death of his father, who was involved in a minor motor vehicle accident and died several days later after a fall and subsequent hospitalization.

The insurer denied the benefits on the basis that the death was not caused by the accident.

The Licence Appeal Tribunal found that the deceased's death was caused by pre-existing medical issues and a subsequent fall, not the motor vehicle accident.

The application was dismissed.