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Psychological benefits and driver assessment granted; physical therapy and orthopaedic assessments denied for lack of objective evidence.
The applicant was injured in a motor vehicle accident and sought medical benefits and cost of examinations under the Statutory Accident Benefits Schedule.
The insurer denied the claims, initially relying on the Minor Injury Guideline (MIG) limits, though it later conceded the applicant was removed from the MIG due to a psychological impairment.
The Tribunal found that the requested psychological services and driver reintegration assessment were reasonable and necessary, preferring the evidence of the applicant's psychologist over the contradictory reports of the insurer's expert.
However, the Tribunal dismissed the claims for physiotherapy, an orthopaedic assessment, and a functional abilities evaluation, finding insufficient objective evidence to support them and noting the applicant's own report that physical therapy was no longer helpful.
The claim for a special award under s. 10 of Regulation 664 was dismissed as the insurer's reliance on its experts' reports was not unreasonable.
Tribunal upheld the Minor Injury Guideline cap, finding no pre-existing conditions or chronic pain precluding recovery.
The applicant sought statutory accident benefits following a rear-end motor vehicle collision.
The respondent insurer determined the injuries fell within the Minor Injury Guideline (MIG) and capped treatment funding at $3,500.
The applicant applied to the Licence Appeal Tribunal, arguing that pre-existing conditions and chronic pain syndrome warranted removal from the MIG.
The Tribunal found no compelling evidence of pre-existing conditions that would preclude recovery within the MIG, preferring the respondent's medical examination over the applicant's physiatry report due to internal contradictions in the latter.
The Tribunal concluded the applicant suffered predominantly soft-tissue injuries falling within the minor injury definition.
As the $3,500 funding limit had been exhausted, the disputed treatment plans and claim for interest were dismissed.
Application for physiotherapy benefits dismissed as applicant failed to prove treatment was reasonable and necessary.
The applicant sought payment for two physiotherapy treatment plans following a motor vehicle accident.
The insurer denied the plans based on section 44 assessments indicating the applicant had achieved maximal medical recovery.
The Tribunal found the applicant failed to demonstrate the treatment plans were reasonable and necessary, noting limited evidence of improvement, the applicant's self-reported normal function, and the lack of objective referrals for treatment.
The application was dismissed.
Insurer ordered to pay for chiropractic and massage therapy treatment plans deemed reasonable and necessary.
The applicant was injured in a motorcycle accident and sought medical benefits for two treatment plans proposing chiropractic and massage therapy.
The respondent insurer denied the plans, arguing they were not reasonable and necessary based on insurer examinations.
The Tribunal found the applicant's family physician and treating clinic records established the treatments were reasonable and necessary, noting the applicant's condition deteriorated when therapy stopped.
The Tribunal ordered the respondent to pay for both treatment plans with interest.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the claimed benefits exceeded the $3,500 limit.
The applicant argued he should be removed from the MIG due to a pre-existing condition, psychological injuries, and chronic pain.
The Tribunal found the applicant's evidence, including expert reports, to be contradictory and unsupported by the objective medical records.
The Tribunal concluded the injuries were minor and dismissed the application, including claims for an award under Regulation 664.
The court struck the plaintiff's claims against the corporate directors personally because the pleadings lacked facts to pierce the corporate veil or establish independent tortious conduct.
The individual defendants, Kastriot Ademaj and Leo Burnaccioni, brought a motion under Rule 21.01(1)(b) to dismiss the claim against them personally, arguing it disclosed no reasonable cause of action.
The plaintiff, Thomas Haggan, brought a cross-motion under Rule 26 to amend his statement of claim to include claims against the individual defendants for intentional infliction of emotional distress.
The court granted the defendants' motion, finding no factual basis to pierce the corporate veil or establish personal liability for the officers acting within their corporate capacity.
The court denied the plaintiff's request to amend the statement of claim, as the proposed amendments lacked sufficient factual underpinning to disclose a reasonable cause of action against the individual defendants.