Nicole A. Dowling

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

The insurer denied income replacement benefits and two treatment plans in April 2021.

The applicant filed an application with the Licence Appeal Tribunal in May 2024, beyond the two-year limitation period.

The Tribunal found that the insurer's denial notices were valid and compliant with the Schedule.

As the applicant provided no submissions to justify extending the limitation period, the Tribunal dismissed the application as statute-barred.

The applicant sought statutory accident benefits following an accident involving an all-terrain vehicle.

The insurer denied benefits, including income replacement benefits, attendant care benefits, and a determination of catastrophic impairment.

The Tribunal found the applicant was excluded from receiving income replacement benefits because he was operating an uninsured vehicle without a valid license.

The Tribunal also dismissed the claims for catastrophic impairment and other benefits, finding the applicant's self-reporting to medical assessors was unreliable and contradicted by video surveillance showing a higher level of functioning than reported.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found she did not sustain a catastrophic impairment as a result of a motor vehicle accident.

The applicant argued the adjudicator erred in law or fact by incorrectly applying the 'but for' test for causation regarding her psychological impairments.

The adjudicator dismissed the request, finding that the correct legal test for causation was applied and that the applicant failed to meet her burden of proof to show the accident was a necessary cause of her psychological impairments.

The adjudicator also found no error in the assessment of the applicant's impairments under the AMA Guides.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision.

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

The applicant argued she sustained a concussion and chronic pain, removing her from the MIG.

The Tribunal found the objective medical evidence, including hospital and family doctor records, did not support a concussion diagnosis.

Furthermore, the Tribunal preferred the respondent's medical assessments, finding the applicant did not demonstrate a functional impairment or meet the criteria for chronic pain.

The application was dismissed, as the injuries were deemed minor and subject to the $3,500 funding limit.

The applicant, who was 12 days old at the time of a minor motor vehicle accident, sought a determination that he sustained a catastrophic impairment.

The applicant's mother claimed he suffered a concussion resulting in developmental delays.

The adjudicator found no objective medical evidence of a head injury from the accident, noting that treating physicians and assessors concluded the applicant's developmental issues were not accident-related.

The mother's testimony was deemed unreliable as it contradicted the medical records.

The application was dismissed.

The applicant failed to attend three scheduled case conferences.

The Tribunal issued a notice of intent to dismiss the application as abandoned.

The applicant provided written submissions and a medical note explaining that the third absence was due to a medical emergency.

The respondent's submissions were filed incorrectly and not considered.

The Tribunal accepted the applicant's medical explanation and declined to dismiss the application, noting the consumer protection purpose of the Schedule, but ordered peremptory attendance at the next case conference.

The applicant requested a reconsideration of a decision denying entitlement to a physiotherapy treatment plan.

The applicant argued the adjudicator erred in law by interpreting section 38(11) of the Statutory Accident Benefits Schedule to require that goods and services be incurred before an insurer is obligated to pay for them following a failure to provide timely notice under section 38(8).

The adjudicator dismissed the request, finding no error of law.

The adjudicator confirmed that section 38(11)(2) serves to compel timely responses from insurers but still requires the insured to actually incur the goods and services described in the treatment plan.

The applicant sought statutory accident benefits for chiropractic and psychological services 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 did not sustain a psychological impairment, chronic pain syndrome, or carpal tunnel syndrome as a result of the accident, and failed to prove a causal link between her severe bilateral neural foraminal stenosis and the accident.

The Tribunal concluded the applicant's injuries were predominantly minor and subject to the MIG limit.

The disputed treatment plans and assessment were deemed not reasonable and necessary.

Claims for an award and interest were dismissed.

The parties sought expenses following a motion hearing where the insurer successfully moved to remove the applicant's counsel due to the inadvertent disclosure of privileged documents.

The arbitrator found that the insurer was wholly successful on the motions and was entitled to its expenses.

However, the arbitrator declined to order the applicant's former counsel to pay the expenses personally, finding that contesting the removal motion was justified given that removal of counsel is a drastic remedy.

The insurer's expenses were fixed at $3,684.76 based on a global approach to preparation time.

The appellants retained the respondent lawyer to represent them in a motor vehicle accident claim.

The respondent issued the statement of claim more than two years after the accident.

The appellants subsequently sued the respondent for professional negligence.

The respondent successfully moved for summary judgment on the basis that the professional negligence action was statute-barred.

On appeal, the Court of Appeal set aside the summary judgment, finding that under s. 5(1)(a)(iv) of the Limitations Act, 2002, the appellants did not discover their claim against the respondent until the defendants in the underlying motor vehicle action amended their statement of defence to plead a limitations defence.