Michael Baura

The applicants were involved in a motor vehicle accident and sought attendant care benefits (ACBs) from their insurers.

Following a reconsideration decision that found an error of law in calculating the quantum of ACBs, the matter was sent back for a written hearing.

The Tribunal determined the quantum of ACBs using the 'minimum award approach' because the applicants failed to provide a breakdown of the actual hours spent on each level of care.

The Tribunal awarded S.K. $5,073.50 and R.K. $5,606.98 in ACBs, plus interest on overdue payments.

Additionally, the Tribunal found that the insurers unreasonably withheld payment of the minimum benefits owing after the reconsideration decision and ordered a lump sum award of $1,500 for each applicant under s. 10 of O. Reg. 664.

The applicant sought an income replacement benefit (IRB) following a motor vehicle accident.

The insurer suspended the IRB after eight months based on insurer's examinations.

The Licence Appeal Tribunal dismissed the application, finding the applicant did not suffer a substantial inability to perform the essential tasks of his pre-accident employment.

The Tribunal preferred the evidence of the insurer's medical assessors, noting significant symptom magnification, a lack of objective physical findings, and surveillance footage showing the applicant working at another job.

The respondent brought a motion to dismiss the applicant's application for statutory accident benefits due to the applicant's failure to comply with a production order and missed deadlines for filing submissions.

The adjudicator denied the request for dismissal, finding that the statutory requirements for dismissal without a hearing were not met and proper notice was not given.

However, as a remedy for the non-compliance, the adjudicator ordered that the applicant could not rely on the unproduced medical records and allowed the respondent to file supplementary submissions.