Jennifer Mitchell

The appellant, who suffered a catastrophic brain injury in a 1999 motor vehicle accident, appealed and sought judicial review of a Licence Appeal Tribunal decision regarding his entitlement to attendant care benefits.

The LAT had awarded a minimal monthly amount, focusing on the care actually provided by his family rather than his need for supervisory care due to his inability to respond to emergencies.

The Divisional Court allowed the appeal and granted the judicial review, finding that the adjudicator erred in law by failing to apply the correct legal test under the 1996 SABS and that the decision was unreasonable.

The matter was remitted for a new hearing before a different adjudicator.

The applicant, who suffered a catastrophic brain injury, sought quantification of attendant care benefits and interest owed following a previous Tribunal decision.

The respondent had paid a lesser amount, unilaterally deducting alleged overpayments without proper notice or explanation.

The respondent argued the application was barred by res judicata and abuse of process due to a previously dismissed motion for clarification.

The Tribunal found it had jurisdiction and that res judicata did not apply as the quantification dispute was a new issue.

The Tribunal ordered the respondent to pay the differential calculated by the applicant's accountant, less an agreed top-up.

Furthermore, the Tribunal granted a 15% special award under s. 10 of Reg. 664, finding the respondent's failure to communicate its rationale for the deductions was unreasonable and inflexible.

The applicant suffered a catastrophic brain injury in a 1999 motor vehicle accident.

The respondent insurer initially paid attendant care benefits (ACB) but reduced and then suspended them in November 2000 without proper notice.

The applicant sought retroactive and ongoing ACB at 24-hour care levels.

The Tribunal found that 24-hour care was not medically necessary, as the applicant had achieved a level of independent living with family support.

The Tribunal upheld the $120.40 monthly rate but ordered a top-up for two six-month periods following changes in living arrangements.

The Tribunal also awarded a 10% penalty under section 10 of Regulation 664 due to the insurer's 20-year delay in reinstating the suspended benefits, along with 2% monthly interest under the 1996 Schedule.

The plaintiffs brought a motion to strike the defendant's jury notice in a personal injury action arising from a motor vehicle accident.

The plaintiffs argued that the anticipated expert evidence was too complex for a jury and that the COVID-19 pandemic would cause undue delay.

The court dismissed the motion as premature, adopting a 'wait and see' approach, noting that the trial was not scheduled until September 2021 and the trial judge retains discretion to strike the jury if necessary.

The applicant was injured in a motor vehicle accident and sought medical benefits for physiotherapy.

The respondent denied the treatment plan, arguing the applicant's injuries fell within the $3,500 Minor Injury Guideline (MIG) limit.

The Tribunal found that the applicant's pre-existing chronic pain, which was exacerbated by the accident, justified removal from the MIG under section 18(2) of the Schedule.

The disputed treatment plan was found to be partially reasonable and necessary, and the respondent was ordered to pay $3,608.06 for kinesiology and occupational therapy assessments.

The applicant sought statutory accident benefits for two chiropractic treatment plans totaling $8,320.00 following a motor vehicle accident.

The insurer denied the claims, arguing the treatments were not reasonable and necessary.

The Licence Appeal Tribunal found that the applicant predominantly suffered psychological injuries rather than the claimed neurological and concussion-related injuries.

Relying on the insurer's medical examinations, the Tribunal concluded the disputed treatment plans were not reasonable and necessary.

The application was dismissed.

The applicants sought interest and a special award under the Statutory Accident Benefits Schedule, alleging the respondent insurer delayed payment of death and funeral benefits following the death of their child in a motor vehicle accident.

The Licence Appeal Tribunal dismissed the claims, finding that the initial application for benefits was incomplete because it lacked essential eligibility documentation.

The insurer paid the benefits within 30 days of receiving the completed application, meaning the payment was never overdue and no interest or special award was payable.

The applicant sought statutory accident benefits for two chiropractic treatment plans totaling $8,320, claiming she suffered post-concussion syndrome and a WAD 3 injury from a motor vehicle accident.

The insurer denied the benefits.

The Licence Appeal Tribunal dismissed the application, finding the treatment plans were not reasonable and necessary.

The Tribunal preferred the insurer's medical examinations, which found no neurological signs or concussion related to the accident, over the applicant's medical reports, which lacked objective testing and were temporally removed from the treatment plans.

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

The insurer denied caregiver benefits based on the OCF-1 application and a medical certificate, arguing the claim was now statute-barred due to the passage of the two-year limitation period.

The applicant argued the denial was invalid because she had never submitted an OCF-10 election form to choose between caregiver and non-earner benefits.

The Arbitrator found that an election was necessary under section 36 of the Schedule and that the OCF-1 alone was insufficient to constitute an election.

Because no valid election was made, the insurer's denial was invalid, and the limitation period did not begin to run.

The applicant was granted the right to elect her preferred benefit without a time limit.