Tanjoyt Deol

The applicant sought medical benefits for chiropractic, massage, acupuncture, and shockwave therapy following a motor vehicle accident.

The adjudicator found that the applicant failed to prove the proposed treatment plans were reasonable and necessary, as her family physician had not recommended such facility-based treatments and the insurer's examination concluded they would not be beneficial.

However, the adjudicator found that the insurer's initial denials of the treatment plans were defective under s. 38(8) of the Statutory Accident Benefits Schedule for failing to provide medical reasons.

Consequently, the insurer was ordered to pay for any expenses incurred during the period of non-compliance, along with interest.

The applicant requested a reconsideration of a Tribunal decision denying her entitlement to chiropractic treatment, psychological services, and interest following a 2016 motor vehicle accident.

The applicant argued the adjudicator made significant errors of law or fact by failing to consider certain medical records and expert evidence.

The Tribunal dismissed the request, finding that the applicant was attempting to re-litigate and reweigh evidence already considered.

The Tribunal maintained that the disputed treatment plans were related to a subsequent 2018 accident rather than the 2016 subject accident.

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

The respondent denied a chiropractic treatment plan and a mental health assessment on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered from psychological impairments caused by the accident, removing her from the MIG.

The Tribunal preferred the evidence of the applicant's treating family physician over the respondent's assessors.

The Tribunal ordered the respondent to pay for the chiropractic treatment plan, the mental health assessment, and applicable interest.

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

The respondent denied a treatment plan for a chronic pain assessment on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to prove on a balance of probabilities that his injuries warranted removal from the MIG based on a pre-existing condition, psychological impairment, or chronic pain.

The medical evidence, including insurer's examinations, demonstrated that the applicant had functional abilities to complete most activities of daily living.

The application was dismissed.

The applicant sought statutory accident benefits for chiropractic and psychological treatment plans following a 2016 motor vehicle accident.

The respondent denied the benefits on the basis that they were not reasonable and necessary.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to provide compelling medical evidence supporting the treatment plans and noting that the plans were largely recommended after a subsequent 2018 accident.

As no benefits were payable, the claim for interest was also dismissed.

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

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on pre-existing jaw pain, psychological issues, and chronic pain.

The Tribunal found insufficient medical evidence to support removal from the MIG, noting a lack of chronic pain diagnosis and preferring the respondent's psychological assessment which found symptom magnification.

As the MIG limits were exhausted, the claims for treatment plans and interest were dismissed.

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

The respondent insurer denied treatment plans for physiotherapy, a psychological assessment, and a chronic pain assessment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the respondent's initial notices denying the treatment plans were defective under s. 38(8) of the Schedule, as they failed to provide adequate medical reasons.

Furthermore, the Tribunal determined that the applicant's injuries fell outside the MIG due to her accident-related psychological impairments, preferring the evidence of the applicant's psychological expert over the insurer's examiner.

The Tribunal concluded that all three disputed treatment plans were reasonable and necessary, and ordered the respondent to pay for them along with interest on overdue payments.

The applicant sought a medical benefit of $2,460.00 for a psychological assessment and interest under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The matter proceeded by way of a written hearing.

The applicant failed to serve and file any written submissions or evidence by the deadline.

Consequently, the adjudicator found that the applicant failed to meet the onus of proving the treatment plan was reasonable and necessary.

The application was dismissed.

The respondent's request for costs was also denied, as the applicant's failure to file submissions did not amount to unreasonable, frivolous, vexatious, or bad faith conduct.

The applicant was injured in a rear-end motor vehicle collision and sought medical benefits beyond the Minor Injury Guideline (MIG) limit, claiming psychological impairments.

The Tribunal found that the applicant's injuries were predominantly minor and that she failed to prove on a balance of probabilities that she suffered a psychological injury warranting removal from the MIG.

The Tribunal placed little weight on the applicant's psychological report because the test scores indicated minimal depression and anxiety, contradicting the psychologist's diagnosis.

The respondent's request for a $50 repayment due to an alleged overpayment was dismissed as there was no evidence of wilful misrepresentation by the applicant.

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

The insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant sustained predominantly minor injuries and failed to prove that pre-existing conditions, psychological injuries, or chronic pain warranted removal from the MIG.

However, because the insurer failed to comply with the strict notice requirements under sections 38(8) and 38(9) of the Schedule when denying a treatment plan for an orthopaedic assessment, the Tribunal ordered the insurer to pay for the assessment along with applicable interest.

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

At the arbitration hearing, the applicant failed to attend.

Her legal representative requested to be removed from the record due to a breakdown in the solicitor-client relationship, which the arbitrator granted.

As the applicant did not participate and presented no evidence to support her claims, the application for arbitration was dismissed.

The insurer was awarded $250 in expenses.