Kaitlyn MacDonell

The applicant sought statutory accident benefits following a 2021 motor vehicle accident.

The Tribunal found the applicant sustained a catastrophic impairment under Criterion 8 due to marked impairments in all four areas of function (activities of daily living, social functioning, concentration, persistence and pace, and adaptation) stemming from accident-related mental and behavioural disorders, including somatic symptom disorder and exacerbated PTSD.

However, the Tribunal dismissed the claims for a non-earner benefit, attendant care benefits, and various treatment plans, finding the applicant did not suffer a complete inability to carry on a normal life and failed to prove the treatment plans were reasonable and necessary.

The applicant was severely injured in a motor vehicle accident and submitted his application for accident benefits (OCF-1) nearly a year late.

The respondent denied benefits on the basis of the delay.

The Tribunal found the applicant had a reasonable explanation for the delay due to his severe brain and physical injuries, and the respondent's failure to adequately communicate the consequences of not filing or to accommodate his disabilities.

The Tribunal ordered the respondent to pay the disputed physiotherapy treatment plan, interest, and a maximum 50% special award under s. 10 of Reg. 664 for unreasonably delaying and withholding benefits.

The applicant, a minor, sought a $10,000 death benefit from the respondent insurer following the death of her father in a motor vehicle accident.

The applicant's mother held a policy with the respondent.

The Tribunal found that the deceased father was not an "insured person" under the mother's policy, as they were not spouses and he was not a dependent.

The application for a death benefit was dismissed.

The applicant sought a $10,000 death benefit under the Statutory Accident Benefits Schedule following the death of her father in a motor vehicle accident.

The respondent denied the benefit on the basis that the deceased was not an insured person under his father's policy.

The Tribunal found that the applicant failed to prove the deceased was principally dependent on his father or stepmother for financial support or care.

As the deceased was not a dependent, he was not an insured person under the policy, and the applicant was not entitled to the death benefit.

The applicant sought a $10,000 death benefit from the respondent insurer following the death of her father in a motor vehicle accident.

The respondent denied the claim on the basis that the deceased was not an "insured person" under the policy issued to the applicant's mother.

The Tribunal found that the deceased was not a named insured, a specified driver, a spouse of the named insured, or a dependent of the named insured.

As the applicant failed to prove the deceased was an insured person under the respondent's policy, the application for a death benefit was dismissed.

The applicant sought statutory accident benefits for chiropractic treatment following a 2017 motor vehicle accident.

The respondent denied the treatment plan, arguing that the injuries were caused by a subsequent 2018 accident and that the treatment was not reasonable and necessary.

The Tribunal found that the applicant satisfied the 'but-for' test for causation, as the medical evidence demonstrated ongoing injuries from the 2017 accident.

The Tribunal also found the treatment plan reasonable and necessary based on the supporting medical reports and clinical notes, giving little weight to the respondent's independent medical examination.

The applicant was awarded the cost of the treatment plan and interest, but the claim for a special award under s. 10 of Reg. 664 was dismissed as the respondent's conduct was not found to be unreasonable.

The applicant requested a reconsideration of a preliminary issue decision which found she was not 'involved in' an accident and thus ineligible for accident benefits.

The applicant had witnessed her boyfriend being struck and killed by a vehicle.

The Tribunal found it had erred in law by previously requiring physical contact with a vehicle to be 'involved in' an accident, and by failing to analyze whether her apprehension of being struck constituted involvement.

However, upon reconsideration, the Tribunal confirmed its original decision.

It held that merely witnessing an accident does not constitute being 'involved in' it, and the applicant's medical evidence showed her psychological injuries arose from witnessing her boyfriend's death, not from her own apprehension of being struck.

The applicant sought statutory accident benefits after witnessing her boyfriend being struck and killed by a motor vehicle.

The respondent denied benefits on the basis that the applicant was not an 'insured person' and was not 'involved in' the accident.

The Licence Appeal Tribunal held that the applicant was not 'involved in' the accident because she was not struck by the vehicle, was not an occupant, and was not physically injured.

As she was not a spouse of the deceased, she did not qualify for nervous shock benefits under the Schedule.

The application was dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied a treatment plan for chiropractic services.

The applicant argued the Tribunal breached procedural fairness by ordering a written hearing without affidavit evidence and by failing to consider his filed evidence.

The Vice-Chair found no breach regarding the hearing format, as the Tribunal has the authority to control its procedure.

However, the Vice-Chair found a material breach of procedural fairness because the original adjudicator explicitly stated they could not locate the applicant's medical report, which had been properly filed and tabbed.

The reconsideration request was granted, the original decision cancelled, and a new written hearing ordered before a different adjudicator.

The applicant sought statutory accident benefits for chiropractic treatment following a motor vehicle accident.

The respondent denied the treatment plan.

The Tribunal found that the applicant failed to prove causation, as he was involved in a subsequent accident that aggravated his injuries, and the medical evidence did not establish that the subject accident was the necessary cause of the impairments.

Furthermore, relying on the insurer's examination report, the Tribunal concluded the treatment was not reasonable and necessary as the applicant had reached maximum medical recovery and derived no long-term benefit from prior extensive chiropractic care.

The application was dismissed, along with claims for interest and an award.

The appellant moved for a stay of an ongoing Licence Appeal Tribunal (LAT) proceeding regarding his claim for statutory accident benefits, pending the determination of his application for judicial review.

The underlying judicial review challenged an interlocutory LAT decision denying the appellant's request to convert a written hearing into an oral hearing.

The Divisional Court dismissed the motion for a stay, finding that the application for judicial review was premature as the LAT proceedings had not yet concluded, and the appellant failed to establish exceptional circumstances to justify court intervention at this stage.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy, medications, massage therapy, and acupuncture.

The respondent denied the benefits, relying in part on an independent medical examination.

The Tribunal found the ongoing in-clinic physiotherapy and prescribed medications were reasonable and necessary, rejecting the respondent's expert opinion that the applicant only needed a home-based exercise regimen.

The Tribunal denied the expenses for massage therapy, physiotherapy, and acupuncture incurred before a treatment plan was submitted.

The applicant was also awarded interest on overdue payments and $300 in costs for the respondent's late motion to change the hearing format.

The plaintiff brought a motion seeking leave to transfer the action to the Simplified Procedure under Rule 76, amend the Statement of Claim to reduce damages to $200,000, and strike the defendant's jury notice.

The motion was brought after the action had been set down for trial.

The court dismissed the motion, finding that the plaintiff failed to establish a substantial or unexpected change in circumstances to justify granting leave under Rule 48.04(1).

Furthermore, the court held that transferring the action would prejudice the defendant's substantive right to a jury trial, and the matter could not be fairly tried within the five-day limit of the Simplified Procedure.

The applicant was involved in a minor rear-end collision while driving to her first day back at work following a prior incident that caused a concussion.

She sought a determination of catastrophic impairment due to mental or behavioural disorders, ongoing income replacement benefits, and approval of several treatment plans.

The Tribunal found that the applicant was not catastrophically impaired, as her function had improved to non-catastrophic levels and validity testing raised concerns about symptom magnification.

The Tribunal also dismissed the claim for ongoing income replacement benefits, finding that her current impairments were not caused by the subject accident.

The applicant was awarded one treatment plan for driver rehabilitation therapy and associated interest, while the remaining treatment plans were denied.

The defendant brought a motion for an extension of time to deliver a jury notice after the close of pleadings in an action arising from a denial of travel insurance coverage.

The failure to deliver the notice was due to the inadvertence of the defendant's original counsel.

The court granted the motion, finding that the delay was not unconscionable and that the plaintiff suffered no prejudice, as discoveries are fact-finding and no trial preparation had yet taken place.

The plaintiff, Natalie Moretto, a 15-year-old at the time, was bitten on the face by the defendant's dog.

The court found the defendant strictly liable under the Dog Owner’s Liability Act.

The defendant failed to prove contributory negligence on the part of the plaintiff.

The court awarded general damages for physical injury and some psychological sequelae, and future care costs for laser treatments and sunscreen.

However, the claim for loss of competitive advantage was dismissed due to insufficient evidence and the inadmissibility of expert opinion.

The applicant was injured in a motor vehicle accident and sought income replacement benefits from her insurer.

The insurer denied the benefits, arguing her injuries fell within the Minor Injury Guideline.

The arbitrator found the applicant credible and accepted medical evidence that she suffered from Chronic Pain Syndrome as a result of the accident.

The arbitrator concluded the applicant suffered a substantial inability to perform the essential tasks of her employment for the first 104 weeks, and a complete inability to engage in any suitable employment thereafter.

The applicant was awarded ongoing income replacement benefits and interest on overdue payments.