Modupe Egunjobi

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

The respondent denied the benefits, and the applicant applied to the Licence Appeal Tribunal.

The matter proceeded to a written hearing, but the applicant failed to file any submissions or evidence.

As the applicant bore the onus of proving entitlement to the benefits and removal from the Minor Injury Guideline, the Tribunal found the applicant failed to meet this burden.

The application was dismissed.

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

The respondent denied benefits and requested the applicant attend Insurer's Examinations (IEs).

The applicant failed to attend multiple scheduled IEs, citing unavailability and transportation issues.

The Tribunal found the applicant failed to provide a reasonable explanation for her non-attendance.

Consequently, the applicant is barred under section 55(1) of the Schedule from proceeding to a hearing, and the application was dismissed.

The applicant's estate sought a non-earner benefit following a motor vehicle accident.

Prior to the accident, the applicant had been diagnosed with progressive, metastatic breast cancer and chronic renal failure.

The Tribunal dismissed the application, finding that the applicant's impairments and declining ability to lead a normal life were caused by her terminal cancer rather than the soft-tissue injuries sustained in the accident.

The Tribunal concluded the applicant did not suffer a complete inability to carry on a normal life as a result of the accident.

Claims for interest and costs were also dismissed.

The applicant insurer sought repayment of an income replacement benefit (IRB) overpayment of $4,800.00, alleging the respondent had returned to work while receiving benefits.

The respondent argued the repayment request was statute-barred because proper notice was not served within 12 months, as the applicant used an incorrect mailing address for the respondent and ordinary mail for her legal representative.

The Tribunal found that while the respondent did not receive the notice due to the incorrect address, the notice was properly served on her legal representative by ordinary mail under section 64(2) of the Schedule.

The Tribunal ordered the respondent to repay the $4,800.00 overpayment.

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

The respondent insurer determined her injuries fell within the Minor Injury Guideline (MIG) and denied a treatment plan for a chronic pain assessment.

The applicant argued she should be removed from the MIG due to chronic pain.

The Licence Appeal Tribunal applied the AMA Guides criteria and found the applicant failed to prove her pain adversely affected her well-being, noting she had returned to full-time work, resumed regular exercise, and did not use prescription pain medication.

The Tribunal concluded the injuries remained within the MIG and the proposed chronic pain assessment was not reasonable and necessary.

The application was dismissed.

The applicant insurer sought repayment of $19,170.90 in attendant care benefits paid to the respondent insured.

The insurer had paid the benefits based on the respondent's mother's Employment Insurance statement, pending further proof of her economic loss.

In a prior Tribunal decision, it was determined that the respondent failed to prove his mother sustained an economic loss in providing care.

The Tribunal found that the insurer paid the benefits directly to the respondent in error, as no evidence of economic loss was ever provided.

The Tribunal ordered the respondent to repay the $19,170.90 plus interest, finding that the insurer had provided proper notice within the 12-month limitation period.

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits for chronic pain and psychological impairments, arguing his injuries fell outside the Minor Injury Guideline (MIG).

The respondent denied the claims, asserting the injuries were predominantly minor.

The Licence Appeal Tribunal found that the applicant's soft tissue injuries and associated chronic back pain were predominantly minor, as there was insufficient evidence of functional impairment or disability.

The Tribunal also found no evidence of psychological injury.

Consequently, the MIG applied, and since the $3,500 limit had been exhausted, the claims for further assessments and treatment were dismissed.

The applicant, who was injured in a motor vehicle accident while riding his bicycle, sought an increased quantum for attendant care benefits provided by his mother.

The applicant argued the rate should reflect the wage his mother would have earned had she not stopped looking for employment to care for him.

The Tribunal found that the applicant failed to prove his mother suffered an economic loss within the meaning of section 3(7)(e)(iii)(b) of the Schedule, as there was insufficient evidence that she would have found employment or been able to work given her own psychological impairments.

The claim for an increased quantum was dismissed.

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

After his representatives withdrew due to a breakdown in the solicitor-client relationship, the applicant failed to attend a pre-hearing discussion and the scheduled arbitration hearing.

As the applicant did not attend to present evidence, he failed to establish his entitlement to the benefits claimed.

The arbitrator dismissed the claims and ordered the applicant to pay the insurer's expenses of the arbitration.

At a pre-hearing discussion for statutory accident benefits, the insurer's representatives attended without the authority to bind the insurer to a settlement, and no one with authority was available.

The arbitrator found this to be a breach of section 279(5) of the Insurance Act and an abuse of process under section 23(1) of the Statutory Powers Procedure Act.

The pre-hearing was adjourned, and the insurer was ordered to pay the applicant's expenses of $75.19 thrown away for the adjournment.