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Applicant not statute-barred from claiming accident benefits where insurer failed to prove consent to electronic delivery.
The applicant was involved in a motor vehicle accident and notified the insurer within seven days.
The insurer sent the application for accident benefits (OCF-1) via email, but the applicant did not submit the completed form until over a year later.
The insurer raised a preliminary issue that the applicant was statute-barred from proceeding with his claim due to the delay.
The Tribunal found that the insurer failed to prove the applicant consented to receive documents electronically or understood the application process, especially given a language barrier.
The Tribunal concluded the applicant had a reasonable explanation for the delay and allowed the application to proceed.
Application for accident benefits dismissed; injuries fall within Minor Injury Guideline and IRB test not met.
The applicant sought statutory accident benefits following a motor vehicle accident.
The Tribunal found that the applicant's injuries fell within the Minor Injury Guideline (MIG), as he failed to establish a pre-existing condition or chronic pain with functional impairment that would warrant removal.
The Tribunal also dismissed the claim for an income replacement benefit, finding the applicant did not meet his onus to establish a substantial inability to perform the essential tasks of his employment, and the respondent properly relied on an Insurer Examination to discontinue the benefit.
Application for income replacement benefits dismissed; applicant failed to prove inability to work.
The applicant sought statutory accident benefits, including an income replacement benefit (IRB) and medication expenses, following a motor vehicle accident.
The respondent denied the benefits and argued the applicant was statute-barred for missing insurer's examinations.
The Tribunal found the applicant was not statute-barred as she attended rescheduled examinations.
However, the Tribunal dismissed the substantive claims, finding the applicant failed to prove a substantial or complete inability to perform the essential tasks of her employment as an Uber driver, relying on the respondent's psychological assessments.
The claims for medication expenses, interest, and a section 10 award were also dismissed.
The court found no implied consent for the stolen vehicle but preserved the negligence claims.
This decision addresses whether the owner of a vehicle (Floyd Thomas) provided implied consent to his son (Robert Thomas) to possess and operate the vehicle, which was involved in a serious accident.
The court found that there was no implied consent, based on clear evidence that Robert knew he did not have permission, and that Floyd had a consistent history of restricting access.
The court declined to dismiss the action entirely, as other negligence issues remained for trial.
Application for accident benefits dismissed; injuries fell within the Minor Injury Guideline.
The insurer denied funding for several treatment and assessment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued that pre-existing conditions and chronic pain precluded his recovery within the MIG.
The Tribunal found no evidence that the applicant's advanced age, prior knee surgery, or lingering shoulder pain impaired his recovery.
Furthermore, the applicant failed to meet the criteria for a chronic pain condition under the AMA Guides.
The Tribunal concluded the applicant sustained minor injuries subject to the $3,500 MIG limit and dismissed the application for the disputed medical benefits and interest.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline limits.
The applicant sought statutory accident benefits following a motor vehicle accident, arguing his injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain.
The Licence Appeal Tribunal found that the applicant failed to meet the burden of proving his injuries fell outside the MIG, noting that the medical evidence, including insurer examinations, supported a diagnosis of soft tissue injuries with no significant functional limitations.
As the $3,500 MIG limit had been exhausted, the applicant's claims for additional chiropractic and psychological treatment plans were denied.
Claims for interest and an award for unreasonable delay were also dismissed.
Application for accident benefits dismissed after applicant failed to file submissions and adjournment was denied.
A written hearing was scheduled, but the applicant failed to file submissions by the deadline and instead requested a 12-week adjournment, citing delays in obtaining productions.
The Tribunal denied the adjournment request, finding it untimely and unsupported by evidence of efforts to obtain the productions.
Proceeding in the applicant's absence pursuant to section 7(2) of the Statutory Powers Procedure Act, the Tribunal dismissed the application because the applicant failed to meet her burden of proof regarding removal from the Minor Injury Guideline and entitlement to the disputed benefits.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline.
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 physical injuries or alleged psychological impairment warranted removal from the MIG.
As the disputed treatment plans proposed treatment beyond the $3,500 MIG limit, the applicant was not entitled to them.
The application was dismissed.
Accident benefits application dismissed; applicant failed to prove injuries warranting removal from MIG.
The respondent denied certain treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant applied to the Licence Appeal Tribunal, arguing that chronic pain and psychological injuries warranted removal from the MIG.
The Tribunal found that the applicant's medical records did not support his claims of chronic pain or accident-related psychological impairment, noting significant gaps in treatment and inconsistencies in self-reporting.
As the applicant failed to meet his burden to establish removal from the MIG, and the disputed treatment plans exceeded the $3,500 funding limit, the application was dismissed.
Applicant not barred from proceeding with LAT application because insurer's notice of examination lacked required medical reasons.
The insurer denied benefits and scheduled insurer's examinations (IEs), including a psychological assessment.
The applicant failed to attend the psychological IE, arguing the notice of examination (NOE) lacked medical reasons.
The insurer argued the applicant was barred from proceeding under s. 55 of the Schedule.
The Tribunal found the NOEs were deficient because they failed to provide medical reasons for the psychological IE, as required by s. 44(5) and the principles in Smith.
Consequently, the applicant was not barred from proceeding with her application.
The Court of Appeal dismissed the appellant's motion to set aside the administrative dismissal of her appeal due to extensive, unjustified delays.
The appellant sought to set aside a motion judge's order dismissing her motion to set aside the administrative dismissal of her appeal.
The appeal had been administratively dismissed twice due to the appellant's repeated failure to meet perfection deadlines, despite extensions.
The Court of Appeal dismissed the appellant's motion, finding no basis to interfere with the motion judge's discretion, noting the extensive delay, the unconvincing justification for non-perfection, and the lack of proof for the appellant's claims of material tampering or respondent non-cooperation.
Accident benefits denied; applicant subject to Minor Injury Guideline and failed to attend insurer examinations.
The applicant was injured in a motor vehicle accident and sought income replacement benefits and medical benefits.
The insurer placed the applicant in the Minor Injury Guideline (MIG) and denied treatment plans beyond the $3,500 limit.
The insurer also suspended income replacement benefits after the applicant failed to attend scheduled insurer examinations.
The Tribunal found that the applicant's injuries were predominantly minor and subject to the MIG limit.
The Tribunal also held that the applicant was not entitled to income replacement benefits because she failed to attend the required insurer examinations, and the Tribunal lacked jurisdiction to consider her explanation for non-attendance until she complied.
Appeal partially allowed; dismissal of action against two defendants upheld, but reversed against remaining defendants due to lack of procedural notice.
The appellants, whose children were previously made Crown wards, commenced a civil action against various individuals and organizations involved in the child protection proceedings.
Two defendants requested the dismissal of the action under Rule 2.1.01 as frivolous and vexatious.
The motion judge dismissed the action against those two defendants, and subsequently amended her reasons to dismiss the action against all defendants without giving the appellants notice.
The Court of Appeal upheld the dismissal against the two moving defendants, finding the action was an abuse of process attempting to relitigate the child protection proceedings.
However, the Court allowed the appeal regarding the other defendants, holding that the motion judge committed a procedural error by dismissing the action against them without providing notice and an opportunity to make submissions as required by Rule 2.1.01.
Insured ordered to repay $17,200 in income replacement benefits paid after return to work.
The applicant insurer sought to recover an overpayment of $17,200.00 in income replacement benefits paid to the respondent after she had returned to full-time work.
The respondent argued that the notice of repayment was defective.
The adjudicator found that the notice met the requirements of section 52 of the Statutory Accident Benefits Schedule and ordered the respondent to repay the overpayment plus interest.
The applicant's request for costs was denied due to insufficient evidence of unreasonable conduct.