Jeremy Magence

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

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

The Licence Appeal Tribunal found that the applicant failed to establish a psychological impairment warranting removal from the MIG, as the evidence lacked independent medical assessments or clinical notes.

However, the Tribunal found that the insurer failed to provide a timely denial for one psychological assessment under section 38(8) of the Schedule.

Consequently, the applicant was entitled to the incurred costs for that assessment for the period of non-compliance, plus interest.

The remaining claims for treatment plans were dismissed.

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

The respondent denied benefits because the applicant failed to submit the OCF-1 application within the 30-day time limit prescribed by the Schedule.

The applicant argued that his health condition prevented him from submitting the form on time.

The Tribunal found that the applicant did not provide a reasonable explanation for the delay, noting a lack of corroborating medical evidence and the applicant's prior experience with the claims process.

The application was dismissed as statute-barred.

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

The respondent denied two treatment plans for physiotherapy and a psychological assessment on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The applicant argued for removal from the MIG based on a pre-existing psychological condition, her age, and an accident-related psychological impairment.

The Tribunal found insufficient medical evidence to support a pre-existing condition that would preclude recovery within the MIG, noting that age alone is not a pre-existing condition.

The Tribunal also gave limited weight to the applicant's psychological report due to its lack of objective testing and reliance on self-reporting.

The application was dismissed, and the applicant was held to the MIG limits.

The applicant sought statutory accident benefits following a motor vehicle accident but was denied by the respondent insurer on the basis that his injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG due to a psychological impairment, a pre-existing anxiety disorder, and chronic pain.

The Licence Appeal Tribunal found that the applicant failed to prove a psychological impairment, as the psychological reports relied on self-reporting and ignored his pre-existing history.

The Tribunal also found insufficient evidence that his pre-existing anxiety precluded recovery within the MIG or that he suffered from chronic pain with functional impairment.

The application was dismissed, and the applicant was denied the disputed treatment plans and interest.

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

The respondent denied treatment plans for psychological and physiotherapy services 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 he suffered from accident-related chronic pain or psychological impairments warranting removal from the MIG.

As the MIG limits were exhausted, the disputed treatment plans were not payable.

The Tribunal also found that the respondent's denial notices complied with s. 38(8) of the Schedule.

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 injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG due to pre-existing conditions (osteoarthritis, diabetes, hypertension, pericardial effusion, and age) and chronic pain.

The Tribunal found that the applicant failed to provide compelling medical evidence that any pre-existing condition would prevent maximal recovery if kept within the MIG.

Furthermore, the Tribunal found insufficient evidence to support a diagnosis of chronic pain with functional impairment.

The applicant's alternative argument that the respondent's denial notices failed to comply with s. 38(8) of the Schedule was also dismissed.

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 Tribunal found that the applicant sustained a concussion, warranting removal from the MIG.

However, the Tribunal dismissed the applicant's claims for chiropractic services, a psychological assessment, and a concussion assessment, finding that the applicant failed to prove the treatment plans were reasonable and necessary.

As no benefits were payable, the claim for interest was also dismissed.

The applicant sought payment for several treatment plans for physiotherapy, chiropractic services, and a catastrophic impairment assessment following a motor vehicle accident.

The Tribunal found that the applicant failed to prove the physical therapy treatment plans were reasonable and necessary, noting a lack of compelling evidence of improvement.

However, because the insurer provided a late denial notice for one treatment plan, the applicant was entitled to payment for the single treatment session incurred during the late period.

The Tribunal also awarded $2,000 for a psychological assessment under criterion 8, finding it was not a duplication of services, but denied the remaining disputed assessment costs and the claim for a special award.

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 sought removal from the MIG, claiming she suffered from chronic pain with a functional impairment and a psychological condition.

The Tribunal found the applicant did not meet her burden of proof.

The chiropractor's diagnosis of chronic pain was rejected as it was outside their scope of practice, and the psychological report lacked psychometric testing to substantiate its provisional diagnosis.

The application was dismissed, and the claims for a chiropractic treatment plan and interest were denied.

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

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

The applicant argued that pre-existing conditions, including age, cardiovascular illness, and prior accident injuries, as well as a psychological diagnosis, warranted removal from the MIG.

The Tribunal found insufficient compelling medical evidence to support removal from the MIG.

As the applicant remained subject to the MIG, the disputed treatment plans were not payable, and the application was dismissed.

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

The respondent denied a treatment plan for physiotherapy and an ambulance expense on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from accident-related chronic pain or other injuries warranting removal from the MIG.

As the MIG limits were exhausted, the disputed treatment and expenses were not payable, and no interest was owed.

The application was dismissed.

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

The respondent denied funding for chiropractic services and a psychological assessment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant claimed to suffer from psychological injuries and chronic pain outside the MIG.

The Tribunal found no compelling evidence of an accident-related psychological injury or chronic pain condition, noting the applicant's failure to produce transcribed clinical notes from his family physician.

The Tribunal concluded the applicant sustained a minor injury, remains subject to the MIG's $3,500 funding limit, and is not entitled to the disputed treatment plans or interest.

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

The respondent denied benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found the applicant was not subject to the MIG due to chronic pain and associated functional impairments.

The Tribunal granted the proposed chiropractic treatment plan, finding it reasonable and necessary to manage pain symptoms, and awarded interest on this plan.

However, the Tribunal denied the claim for a non-earner benefit, as the applicant failed to prove a complete inability to carry on a normal life, and denied the psychological assessment due to insufficient evidence linking the psychological impairments to the accident.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's determination that her injuries fell within the Minor Injury Guideline (MIG).

The applicant claimed exceptions to the MIG based on pre-existing conditions, chronic pain, and psychological impairment.

The Tribunal found that the medical evidence, including reports from the respondent's section 44 assessors, supported that the injuries were predominantly minor soft tissue injuries.

The applicant failed to prove any pre-existing condition, chronic pain with functional impairment, or psychological impairment that would warrant removal from the MIG.

Consequently, the disputed treatment plans for psychological and chiropractic services were denied, and the application was dismissed.

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

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

The applicant argued that a pre-existing condition of diabetes, psychological impairments, a concussion, and chronic pain warranted removal from the MIG.

The Tribunal found that the applicant failed to prove on a balance of probabilities that his injuries fell outside the MIG.

As the $3,500 MIG limit had been exhausted, the disputed treatment plans for psychological and chiropractic services were not payable.

The application was dismissed.

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

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

The Tribunal found that the applicant sustained predominantly soft-tissue injuries and failed to establish a pre-existing condition or chronic pain syndrome that would warrant removal from the MIG.

However, the Tribunal ordered the insurer to pay for goods and services incurred under one treatment plan because the insurer failed to provide a compliant denial notice within the required 10-business-day period under section 38 of the Schedule.

The plaintiffs brought a Rule 7 motion for approval of a $140,000 tort settlement for a minor who suffered a fractured femur in a motor vehicle accident.

The court approved the settlement quantum but found the proposed legal fees and disbursements excessive.

The court reduced the lawyer's fees from $30,000 to $20,000, denied a disbursement for a nurse practitioner, reduced photocopying costs, and refused to approve payment of a chiropractic account from the tort settlement without further explanation.

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

The respondent insurer denied certain medical benefits and assessments on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's injuries, including a cervical strain and a left shoulder calcific tendinosis, were predominantly minor injuries or unrelated to the accident.

The Tribunal concluded that the applicant did not suffer from chronic pain caused by the accident and that the disputed treatment plans were not reasonable and necessary.

The application was dismissed.

This endorsement addresses a Rule 7 motion for approval of a minor's settlement that has been significantly delayed and previously rejected due to deficient materials.

The court notes multiple instances of non-compliance and orders the plaintiff's counsel to file fresh motion materials by a specified date, along with an explanation for the prolonged delays between January 2019 and April 2020.

The quantum of the proposed settlement has not changed since 2018, and the court emphasizes the need for timely resolution.

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

A dispute arose and the applicant applied for arbitration.

During a pre-hearing discussion, the applicant's counsel advised of a breakdown in the solicitor-client relationship and sought to be removed from the record, with the applicant's consent.

The applicant also sought to withdraw the arbitration application without costs.

The insurer consented to both requests.

The arbitrator ordered the removal of the solicitors from the record and the withdrawal of the arbitration without costs.