Naguena Alingary

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits, which the respondent insurer denied on the basis that the injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's injuries warranted removal from the MIG due to chronic pain with functional limitations and psychological injuries, preferring the evidence of the applicant's treating professionals over the insurer's assessors.

The Tribunal ordered the respondent to pay for the disputed chiropractic services, psychological assessment, and psychological treatment, finding them reasonable and necessary.

The claims for physiatry and orthopedic assessments were dismissed as the applicant had already been diagnosed with chronic pain and failed to prove their necessity.

Interest was awarded on overdue payments.

The applicant sought a special award under s. 10 of Reg. 664, alleging the respondent unreasonably delayed the approval of a psychological treatment plan.

The respondent argued the claim was barred by res judicata, as a previous application for a special award regarding a different treatment plan had been dismissed.

The Tribunal found that issue estoppel did not apply because the applications concerned different treatment plans.

On the merits, the Tribunal dismissed the claim for a special award, finding the three-and-a-half-month delay in approving the plan was not excessive, imprudent, or in bad faith.

The respondent's request for costs was also dismissed, as the applicant's conduct was not frivolous or vexatious.

The applicant sought a non-earner benefit and interest following a motor vehicle accident.

The respondent denied the benefits on the basis that the applicant did not suffer a complete inability to carry on a normal life.

The Tribunal applied the Heath framework and found that the applicant had resumed substantially all pre-accident activities, including graduating from his MBA program and managing activities of daily living independently.

The application was dismissed as the applicant failed to demonstrate a complete inability to carry on a normal life.

The applicant sought medical benefits for acupuncture and catastrophic determination assessments following a motor vehicle accident.

The Licence Appeal Tribunal found that the acupuncture treatment plans were not reasonable or necessary, as the applicant had achieved maximum therapeutic benefit and met his goals of returning to work and daily activities.

The Tribunal also denied the catastrophic determination assessments because the applicant provided no submissions to prove entitlement.

The application was dismissed in its entirety.

The applicant was injured in a rear-end motor vehicle accident and sought a physiotherapy treatment plan of $3,551.04.

The respondent insurer denied the plan, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) limit of $3,500.

The Tribunal found that the applicant's ongoing pain symptoms, functional limitations, and physical impairments took his injuries outside the MIG.

The Tribunal ordered the respondent to pay for the treatment plan, plus interest, and denied the respondent's request for costs.