Sharon Mackay

The applicant sought statutory accident benefits after allegedly being forced off the road while riding an e-bike by an unidentified motorist.

The respondent denied benefits, arguing the applicant failed to prove the involvement of an automobile.

The Licence Appeal Tribunal found the applicant's evidence regarding the incident to be inconsistent and unreliable, noting contradictions between his testimony, medical records, and statements to police.

The Tribunal concluded the applicant failed to meet the purpose test to establish he was involved in an 'accident' under section 3(1) of the Schedule.

The application was dismissed.

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

The respondent denied medical benefits on the basis that the policy limits were exhausted, leading the applicant to apply to the Licence Appeal Tribunal.

The respondent raised a preliminary issue arguing the Tribunal lacked jurisdiction to determine optional medical and rehabilitation policy limits, characterizing it as a contractual dispute for the courts.

The Tribunal held that under section 280 of the Insurance Act, it has exclusive jurisdiction over disputes regarding entitlement to and the amount of statutory accident benefits, including optional benefits.

The Tribunal also determined the quantum of the applicant's income replacement benefits and found that the respondent was not entitled to recover alleged overpayments because its notices failed to comply with the requirements of section 52 of the Schedule.

The appellant sought income replacement benefits (IRBs) and medical benefits following a motor vehicle accident.

The insurer terminated IRBs on the basis that the appellant no longer suffered a substantial inability to perform the essential tasks of her employment.

The Tribunal found that the appellant failed to prove she was substantially unable to perform her pre-accident employment tasks after the termination date, noting her subsequent employment history and an intervening hand injury.

A claim for physiotherapy was denied because the treatment plan was not entered into evidence.

However, the Tribunal ordered the insurer to pay for an occupational therapy in-home assessment because the insurer failed to provide proper medical reasons for denying the treatment plan, making it payable if incurred.

The applicant, injured in a motor vehicle accident, sought non-earner benefits from the respondent insurer.

The Licence Appeal Tribunal applied the Heath test to compare the applicant's pre- and post-accident activities.

The Tribunal found that the applicant's post-accident activities, including caring for his daughters, cleaning, and watching movies, were not so significantly restricted as to constitute a complete inability to carry on a normal life.

The application for non-earner benefits, interest, and costs was dismissed.

The applicant was injured in two motor vehicle accidents and sought statutory accident benefits.

The parties entered into a settlement agreement, and the applicant signed a full and final release and a settlement disclosure notice.

The applicant subsequently filed a second application seeking payment of a disputed treatment plan, arguing it was not included in the settlement.

The respondent brought a motion to strike the application.

The Tribunal found that the settlement agreement was valid, full, and final, and explicitly included the disputed treatment plan amount.

The application was dismissed.