Lisa Bishop

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

The insurer denied medical benefits and income replacement benefits (IRBs) on the basis that the injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant failed to prove his injuries warranted removal from the MIG.

Furthermore, the applicant failed to demonstrate a substantial inability to perform the essential tasks of his pre-accident employment, disentitling him to IRBs.

Claims for an accounting report, interest, and an award were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits, attendant care benefits, medical benefits, and the cost of various assessments.

The Licence Appeal Tribunal dismissed the application in its entirety.

The Tribunal found that the applicant's ongoing physical and psychological impairments were caused by pre-existing conditions and intervening injuries, including a slip and fall and a groin injury sustained during home exercises, rather than the accident.

Consequently, the applicant failed to establish that the claimed benefits and assessments were reasonable and necessary as a result of the accident.

The plaintiff brought a motion to transfer their action from Windsor to the Toronto Region, which the defendant did not oppose.

The court dismissed the motion, finding that the plaintiff failed to provide sufficient admissible evidence to meet the requirements of Rule 13.1.02(2) of the Rules of Civil Procedure.

The judgment highlighted issues with the affidavit evidence, including hearsay and lack of clarity regarding the plaintiff's residence and the connection of the case to Toronto, emphasizing that consent alone is insufficient for a venue transfer.

The applicant sought statutory accident benefits for chiropractic services and a psychological assessment following a motor vehicle accident.

The respondent denied the benefits and requested insurer's examinations.

The Tribunal found that the applicant failed to establish the reasonableness and necessity of the disputed treatment plans, noting a lack of objective medical evidence and significant credibility issues with a pre-screen psychological assessment report that appeared to be copied from another patient.

The application was dismissed.

The Tribunal awarded $100 in costs to the respondent, finding that the applicant engaged in vexatious and bad faith conduct by misrepresenting evidence and submitting a questionable medical report.

The applicant was injured in a motor vehicle accident and sought medical benefits for physiotherapy.

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

The applicant argued that his injuries warranted removal from the MIG due to a pre-existing condition and chronic pain syndrome.

The Tribunal found that the applicant failed to demonstrate that his injuries fell outside the MIG or that he suffered from chronic pain syndrome.

As the MIG limits were exhausted, the benefits and an award for unreasonable delay were denied.

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

The respondent determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied several treatment plans.

The applicant argued his injuries were not minor and that a pre-existing condition from a 2016 accident removed him from the MIG.

The Tribunal found insufficient medical evidence to support a pre-existing condition that would prevent maximal recovery within the MIG limit.

The Tribunal concluded the applicant's injuries were predominantly minor and that the disputed treatment plans for physiotherapy, medical services, and assessments were not reasonable and necessary.

Claims for a special award and interest were also dismissed.

The applicant sought medical and rehabilitation benefits 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 failed to prove her injuries warranted treatment outside the MIG, as there was insufficient evidence of a pre-existing condition or psychological impairment.

However, the Tribunal awarded $200 for a psychological assessment because the respondent failed to provide a compliant denial notice within the required 10 business days under section 38(8) of the Schedule.

Claims for further physiotherapy and an award under Ontario Regulation 664 were dismissed.

The applicant sought statutory accident benefits for psychological services, chiropractic services, and a driver anxiety assessment following a motor vehicle accident.

The insurer denied the benefits.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to establish on a balance of probabilities that the requested treatments and assessment were reasonable and necessary as a result of the accident.

The Tribunal noted the applicant's pre-existing psychological conditions and found insufficient evidence linking her current symptoms to the accident.

Claims for interest and an award under Regulation 664 were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically funding for a functional impairment evaluation, a neurological assessment, and an attendant care assessment.

The insurer denied the treatment plans.

The Licence Appeal Tribunal found that the applicant failed to establish on a balance of probabilities that the assessments were reasonable and necessary, noting a lack of supporting medical evidence and inconsistencies between the applicant's self-reported activities and the requested assessments.

The Tribunal also found that the insurer's denial notices complied with section 38(8) of the Schedule and did not unreasonably withhold or delay payments.

The application was dismissed.

The applicant, who was injured when his skateboard impacted a motor vehicle, sought non-earner benefits, attendant care benefits, and medical benefits under the Statutory Accident Benefits Schedule.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove a complete inability to carry on a normal life, as he had returned to full-time university studies and resumed sports.

The Tribunal also found that the attendant care benefits were not proven to be incurred or reasonable and necessary, and that the disputed portions of the occupational therapy and psychological treatment plans were not established as reasonable and necessary.

The respondent insurer requested a reconsideration of a decision finding that the applicant was not precluded from applying to the Tribunal for failing to attend scheduled insurer's examinations.

The insurer argued the Tribunal applied an inappropriately stringent standard to the reasons provided in the examination notices and failed to consider the applicant's lack of medical evidence.

The Tribunal dismissed the request, finding no error of law or fact, and affirmed that an insurer must provide sufficient medical reasons in its notice before relying on section 55(2) of the Schedule to bar an application.

The insurer sought reconsideration of a decision ordering it to pay a $1,500 special award on two files for unreasonably withholding or delaying payment of attendant care benefits.

The insurer argued that the previous reconsideration decision did not explicitly order payment and that it was simply following the Tribunal's procedure to determine the final quantum.

The Vice-Chair dismissed the request, finding that the previous decision had settled a minimum amount due, which the insurer accepted and failed to pay for 10 months.

The Tribunal held that in the context of consumer protection legislation, it was unreasonable for the insurer to delay paying the undisputed minimum amount while litigating a minor remaining difference.

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

The respondent denied treatment plans for chiropractic/massage therapy, a psychological assessment, and psychological treatment.

The Tribunal found the chiropractic and massage therapy plan was not reasonable and necessary, preferring the respondent's physiatry assessment which recommended a home exercise program.

However, the Tribunal found the psychological assessment and treatment plans were reasonable and necessary, concluding that the accident exacerbated the applicant's pre-existing anxiety and depression.

The Tribunal rejected the respondent's psychiatric assessment because it failed to address the applicant's in-vehicle anxiety and lacked objective testing.

The applicant's claim for a special award under Ontario Regulation 664 was dismissed as the respondent had relied on its own medical assessments.

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

The respondent insurer determined her injuries fell within the Minor Injury Guideline (MIG) and denied further benefits.

The applicant applied to the Licence Appeal Tribunal, arguing she suffered from chronic pain and neurological issues warranting removal from the MIG.

The Tribunal found the applicant failed to establish her injuries were more than minor soft tissue injuries.

As the applicant had exhausted the $3,500 funding limit under the MIG, the claims for further medical benefits and examination costs were dismissed.

The Tribunal also dismissed the claim for an award under Ontario Regulation 664, finding no evidence the insurer unreasonably withheld or delayed payments.

The applicant sought funding for a chronic pain assessment following a motor vehicle accident.

The insurer denied the treatment plan, but the applicant argued the denial notices were defective under s. 38(8) of the Schedule.

The Tribunal found that the insurer's denial letters failed to provide specific medical reasons or details about the applicant's condition, rendering them non-compliant.

Consequently, under s. 38(11), the treatment plan became payable without an analysis of reasonableness and necessity.

The Tribunal awarded the cost of the assessment plus interest, but declined to order an award under O. Reg. 664, finding the insurer's conduct was not excessive or imprudent.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found his claims fell within the Minor Injury Guidelines (MIG) and denied further medical benefits.

The applicant argued the Tribunal made significant errors of law and fact, specifically regarding the mandatory payment provisions under s. 38(11) of the Statutory Accident Benefits Schedule and the consideration of a psychological assessment.

The adjudicator found no significant errors of law or fact that would have changed the outcome, noting that the proposed treatment plans were not reasonable and necessary.

The request for reconsideration was dismissed.

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

The respondent denied medical benefits, attendant care, and the cost of a psychological assessment on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued she should be removed from the MIG due to psychological impairments, chronic pain, and a pre-existing shoulder injury.

The Tribunal found that the applicant failed to provide compelling medical evidence to support her removal from the MIG.

Furthermore, the Tribunal concluded that the disputed treatment plans and assessment were not reasonable and necessary, and dismissed the claim for attendant care benefits due to a lack of evidence.

The applicant, a pedestrian struck by a vehicle, sought statutory accident benefits for physiotherapy and a chronic pain program.

The insurer denied the treatment plans based on insurer examinations concluding the applicant had reached maximum medical improvement.

The Tribunal found the applicant's chronic pain diagnosis more consistent with the evidence and approved the treatment plans as reasonable and necessary.

The Tribunal awarded interest on overdue payments but declined to order a special award under Regulation 664, finding no evidence the insurer acted unreasonably or in bad faith.

Both parties requested reconsideration of a previous Tribunal decision regarding statutory accident benefits.

The respondent argued the Tribunal erred in awarding psychological services and an award for a functional impairment assessment, and breached procedural fairness by deeming the assessment incurred under s. 3(8) without notice.

The applicant argued the Tribunal erred by requiring attendant care services to be incurred.

The Tribunal upheld the respondent's request in part, finding a breach of procedural fairness regarding the s. 3(8) deeming provision, and struck that portion of the decision.

The applicant's request was dismissed in full.

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

The respondent denied certain treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been exhausted.

The applicant argued her physical injuries and pre-existing conditions, including depression and anxiety, removed her from the MIG.

The Licence Appeal Tribunal found the applicant's physical injuries were predominantly sprains and strains falling within the MIG.

Furthermore, the Tribunal held there was insufficient medical evidence to establish that any pre-existing condition prevented the applicant from achieving maximal recovery from her minor injuries.

As the MIG limit was exhausted, the disputed treatment plans were not payable, and claims for interest and a special award were dismissed.