11 total
Application for accident benefits dismissed; applicant failed to prove grounds for MIG removal.
The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that his injuries fell within the Minor Injury Guideline (MIG).
The applicant argued for removal from the MIG based on an alleged psychological condition and pre-existing chronic back pain.
The Licence Appeal Tribunal found the medical evidence insufficient to establish an accident-related psychological condition or that the pre-existing condition precluded recovery within the MIG.
The application was dismissed, and the applicant remained subject to the $3,500 MIG limit, rendering the disputed treatment plans moot.
Applicant found not catastrophically impaired; claims for accident benefits and treatment plans dismissed.
The applicant sought a determination that she sustained a catastrophic impairment as a result of a motor vehicle accident, along with entitlement to various accident benefits, an award, and interest.
The Tribunal evaluated the medical evidence under Criterion 7 and Criterion 8 of the Statutory Accident Benefits Schedule.
The Tribunal preferred the respondent's expert evidence, finding the applicant did not have Complex Regional Pain Syndrome and that her physical and psychological impairments did not meet the catastrophic impairment thresholds.
As the applicant's non-catastrophic medical rehabilitation limits were exhausted, the claims for attendant care and treatment plans were dismissed.
The claims for an award and interest were also dismissed.
Accident benefits application dismissed as statute-barred due to unreasonable two-year delay in reporting.
The applicant, a pedestrian involved in a motor vehicle accident, sought statutory accident benefits but did not notify the insurer until nearly two years after the accident.
The insurer denied the claim on the basis that the applicant failed to comply with the time limits under section 32 of the Statutory Accident Benefits Schedule.
The Tribunal found that the applicant's explanation for the delay—that she did not have the third party's insurance information and was busy with work and family—was not reasonable.
The Tribunal concluded that the insurer was prejudiced by the delay and dismissed the application as statute-barred.
Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from Minor Injury Guideline.
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 argued for removal from the MIG based on chronic pain, psychological impairment, and pre-existing conditions (degenerative disc disease, scoliosis, and kyphosis).
The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from chronic pain or a psychological impairment caused by the accident.
The Tribunal also found no compelling evidence that his pre-existing conditions prevented his recovery within the MIG limits.
The application for disputed treatment plans and interest was dismissed.
Application for accident benefits dismissed where applicant failed to adduce evidence to prove entitlement.
The applicant sought income replacement benefits and medical benefits following a motor vehicle accident.
The applicant failed to properly serve summonses on his intended witnesses, resulting in the respondent's motion to quash the summonses being granted.
At the hearing, the applicant chose not to give oral evidence and provided no substantive documentary evidence to support his claims.
The Tribunal dismissed the application, finding the applicant failed to meet his burden of proving entitlement to the claimed benefits on a balance of probabilities.
Applicant found catastrophically impaired due to accident exacerbating pre-existing psychological condition; partial benefits awarded.
The applicant was involved in a motor vehicle accident and sought statutory accident benefits, including a determination of catastrophic impairment due to a mental or behavioural disorder.
The respondent denied the benefits, arguing the applicant's psychological impairments pre-dated the accident.
The Tribunal found that the accident exacerbated the applicant's pre-existing condition, resulting in a marked class 4 impairment in her adaption to the workplace.
The Tribunal concluded the applicant was catastrophically impaired and awarded attendant care benefits of $931.57 per month, along with partial entitlement to claimed medical, rehabilitation, and examination expenses.
Order dismissing action for delay set aside after plaintiff was inadvertently left in Zoom waiting room.
The plaintiff brought a motion to set aside an order dismissing his motor vehicle accident claim for delay.
The plaintiff had been inadvertently left in the Zoom waiting room during the original motion.
The court set aside the dismissal order, finding that the plaintiff's absence was due to a technical mistake.
Reviewing the underlying motion to dismiss for delay, the court found the delay was largely attributable to the plaintiff's former counsel and the COVID-19 pandemic, was not intentional or contumelious, and did not create a substantial risk to a fair trial.
The motion to set aside was granted and a timetable was set for the action to proceed.
Applicant's pre-existing conditions and chronic pain diagnosis remove her injuries from the Minor Injury Guideline.
The applicant sought medical and rehabilitation benefits following a motor vehicle accident.
The insurer denied the claims, arguing the injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant's pre-existing conditions, including knee osteoarthritis and abdominal issues, as well as a post-accident chronic pain diagnosis, removed her from the MIG.
The Tribunal ordered the insurer to pay for multiple treatment plans and a chronic pain assessment, finding them reasonable and necessary, but denied the cost of a medical bracelet and the applicant's request for costs.
Reconsideration of decision denying income replacement benefits dismissed; applicant's unemployment was due to layoff, not injury.
The applicant sought reconsideration of a Licence Appeal Tribunal decision denying her claim for an income replacement benefit following a motor vehicle accident.
The applicant argued that the Tribunal misapplied the test for eligibility, failed to state the standard of proof, and improperly considered certain evidence.
The Executive Chair dismissed the request for reconsideration, finding that the Tribunal correctly concluded the applicant was not working due to a temporary layoff rather than a substantial inability to perform her pre-accident employment.
The Chair also found no error in the Tribunal's application of the standard of proof or its treatment of the evidence.
Income replacement benefits denied as applicant failed to prove substantial inability to perform employment tasks.
The applicant sought income replacement benefits following a motor vehicle accident.
The respondent denied the benefits based on independent medical examinations.
The Tribunal found that the applicant failed to prove she suffered a substantial inability to perform the essential tasks of her pre-accident employment.
The evidence indicated that the applicant's periods of unemployment were due to temporary layoffs rather than accident-related impairments, and she had actively sought and obtained other employment.
The application was dismissed.
Arbitration dismissed and costs awarded to insurer after applicant abandoned claim and lost contact with representative.
The applicant failed to attend multiple pre-hearings and lost contact with his representative.
The representative brought a motion to be removed from the record, and the insurer brought a motion to dismiss the arbitration and for costs.
The arbitrator granted the representative's request to be removed, dismissed the arbitration due to the applicant's failure to proceed, and awarded $678.00 in costs to the insurer.