Michelle Cristin Mainprize

The applicant sought statutory accident benefits for occupational therapy services following a motor vehicle accident.

The matter was scheduled for a written hearing, but neither party filed submissions.

The parties confirmed via email that the matter had settled, but the applicant failed to file a Notice of Withdrawal.

Proceeding under s. 7(2) of the Statutory Powers Procedure Act, the adjudicator dismissed the application because the applicant failed to meet the burden of demonstrating entitlement to the benefits.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied additional Attendant Care Benefits.

The applicant argued the Tribunal committed a material breach of procedural fairness by ignoring evidence, made errors of fact and law regarding the assessment of care needs, and demonstrated a reasonable apprehension of bias.

The Tribunal dismissed the request, finding that the original decision properly weighed the competing Form 1s and accompanying reports, correctly applied the requirement that expenses be incurred, and that the applicant failed to establish any specific grounds for bias beyond mere disagreement with the outcome.

The applicant sought various statutory accident benefits following a motor vehicle accident, including increased attendant care benefits, multiple treatment plans, and expenses for eyeglasses.

The Licence Appeal Tribunal dismissed all claims.

The Tribunal found the applicant failed to provide evidence of incurred past attendant care expenses and preferred the respondent's occupational therapy assessment for ongoing care, concluding that 24/7 care was not justified.

The claims for treatment plans and assessments were dismissed due to a complete lack of supporting evidence, and the claims for eyeglasses were denied because the expenses had not been incurred.

The applicant requested a reconsideration of a motion order which found he did not provide a reasonable explanation for filing his application for statutory accident benefits outside the prescribed time limits.

The applicant argued the Tribunal made errors of fact regarding his knowledge of the SABS, his belief that his injuries would resolve, and the adequacy of the insurer's notice of consequences for late filing.

The Tribunal dismissed the request, finding no significant legal or evidentiary mistakes that would warrant reconsideration.

The applicant sought statutory accident benefits for dental treatment, claiming a motor vehicle accident exacerbated prior damage to a tooth, requiring an implant or bridge.

The respondent denied the claim, arguing the treatment was not reasonable and necessary and that the tooth was already irreparably damaged before the accident.

The Tribunal found that the applicant failed to prove the dental treatment would not have been required but for the accident, as his own dentist's records did not connect the damage to the accident and the respondent's expert concluded the tooth needed replacement prior to the accident.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought enhanced statutory accident benefits, claiming she suffered a catastrophic impairment due to a brain injury resulting in a Glasgow Coma Scale (GCS) score of 9 or less.

The respondent argued the low GCS scores were caused by intubation and sedation rather than brain impairment.

The adjudicator found that the applicant's brain impairment and lowered GCS scores were directly caused by the brain injury and hypovolaemia resulting from the accident.

The adjudicator concluded the applicant suffered a catastrophic impairment and is entitled to enhanced benefits.

Intact Insurance Company brought an application seeking a declaration on the interpretation of s. 44(1) of the Statutory Accident Benefits Schedule (SABS), specifically whether an insured is required to sign any consent form dictated by the insurer for a s. 44 examination.

The respondent, Anne Beaudry, argued that such consent forms must be "reasonable and justifiable." The court found that any required consent form must be "reasonable" based on the language of s. 44, the insurer's duty of utmost good faith, and the Unfair and Deceptive Practices Regulation.

The court dismissed Intact's request to unilaterally dictate consent terms, emphasizing the need for reasonableness and negotiation.

The applicant, who sustained catastrophic impairments in a motor vehicle accident, brought a motion for an interim payment of $427,751 for home modifications.

The insurer had requested a section 44 examination involving both a housing expert and an occupational therapist to assess the claim.

The applicant consented to the housing expert but refused to attend an examination involving the occupational therapist.

The arbitrator dismissed the motion, finding that the insurer's request for an occupational therapist assessment was reasonable and necessary to evaluate the applicant's functional requirements.

Because the applicant failed to attend the section 44 examination, he was in breach of the Schedule, making an award of interim benefits inappropriate.

The applicant applied for statutory accident benefits following a motor vehicle accident.

The matter proceeded to arbitration, but the applicant and his representative failed to appear at the hearing despite proper notice.

The arbitrator dismissed the application for arbitration due to the applicant's failure to present evidence to support his claims.

The insurer was awarded $1,500 in expenses for its preparation and attendance.

The insurer brought a motion for production of various medical and financial records.

The applicant subsequently sought an adjournment of the hearing and an order to change his representative of record.

The arbitrator granted the change of representative and adjourned the hearing to allow new counsel to prepare.

On the production motion, the arbitrator ordered the applicant to produce specific diagnostic scan reports and clinical notes from certain treating physicians, but declined to order production of records beyond one year pre-accident, personal bank statements, or records from third parties who had not been given notice.

The applicant was injured in a motor vehicle accident and sought payment for $1,828.00 in medical benefits for treatment received at a health clinic.

The insurer denied the treatment plan based on perceived 'red flags' and a subsequent Designated Assessment Centre (DAC) report that concluded the treatment was not reasonable and necessary.

The arbitrator gave little weight to the DAC report due to factual errors and internal inconsistencies, preferring the evidence of the treating chiropractor and the applicant.

The arbitrator found the treatment was reasonable and necessary, ordered the insurer to pay the medical benefit with interest, and deferred the issues of a special award and expenses to a resumed hearing.

The applicant's law firm brought a motion to withdraw as her representative, citing an inability to contact her to obtain instructions following a pre-hearing settlement offer.

The arbitrator dismissed the motion, noting that the firm failed to provide a supporting affidavit detailing its attempts to contact the client over the preceding months, relying instead only on recent affidavits of attempted service.

The dismissal was without prejudice to a further motion on better material, and the arbitration hearing dates were adjourned to allow further attempts to contact the applicant.