O. Itse Ezomo

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that granted her a non-earner benefit but denied her request for an award under s. 10 of Reg. 664.

The applicant argued the Tribunal failed to provide adequate reasons for denying the award.

The Vice-Chair agreed, finding the original reasons were conclusory and failed to address the applicant's submissions regarding the insurer's adjusting of the non-earner benefit.

However, upon conducting a fresh review of the award claim, the Vice-Chair concluded the applicant failed to prove the insurer's conduct was unreasonable.

The insurer was entitled to rely on its medical evidence and was not required to conduct updated assessments.

The original decision denying the award was confirmed, but minor typographical errors regarding the non-earner benefit entitlement were corrected pursuant to Rule 17.

The applicant requested a reconsideration of a previous LAT decision that denied her motion to exclude four insurer's examination (IE) reports and found she was not entitled to post-104-week income replacement benefits (IRBs).

The applicant argued the adjudicator erred in law by misstating the test under s. 44(5)(a) of the Schedule and erred in fact by improperly weighing medical and surveillance evidence.

The adjudicator acknowledged a minor misstatement during oral reasons but concluded it would not have changed the outcome, as the collective correspondence provided sufficient medical reasons for the IEs.

The adjudicator also found no errors of fact in the weighing of evidence regarding the applicant's entitlement to IRBs.

The request for reconsideration was dismissed.

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

The respondent insurer denied certain benefits, asserting the applicant's injuries fell within the Minor Injury Guideline (MIG), and requested the applicant attend insurer's examinations (IEs) under s. 44 of the Schedule.

The applicant refused to attend, arguing that the Schedule does not permit an IE to determine the applicability of the MIG.

The respondent requested a preliminary issue hearing to determine if the application was barred under s. 55.

The Tribunal found that the applicant's interpretation of the Schedule was incorrect and that she was required to attend the IEs.

Because the applicant failed to attend the IEs without a reasonable explanation, she was barred from proceeding with her application.

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

The respondent raised a preliminary issue that the applicant was barred from proceeding with her Tribunal application under s. 55(1) 2. of the Schedule for failing to attend scheduled insurer examinations.

The Tribunal found that the respondent's requests for insurer examinations regarding the non-earner benefit and assistive devices were reasonably necessary and that the applicant failed to provide a reasonable explanation for her non-attendance.

Consequently, the applicant was barred from proceeding with her claims for the non-earner benefit and assistive devices, while her other medical benefit claims were permitted to proceed.

The applicant was injured in a motor vehicle accident while riding his bicycle and sought statutory accident benefits, including non-earner benefits and the cost of a psychological assessment.

The Licence Appeal Tribunal found that the applicant did not suffer a complete inability to carry on a normal life, as he was able to perform substantially all of his pre-accident activities with only minor restrictions.

The claim for non-earner benefits was dismissed.

However, the Tribunal awarded $1,450.00 for a short course of psychotherapy to address the applicant's residual psychological symptoms, including intrusive memories and anxiety related to cycling.

The applicant sought medical benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) limit, which had been exhausted.

The applicant claimed removal from the MIG based on psychological impairments and chronic pain.

The Tribunal found insufficient evidence of a psychological impairment or chronic pain, noting the applicant's post-accident life and functional capacity remained largely unchanged.

The Tribunal concluded the injuries were minor and fell within the MIG.

Claims for an award and costs were also dismissed.

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

The respondent insurer determined the injuries fell within the Minor Injury Guideline (MIG) and denied several treatment and assessment plans.

The applicant applied to the Licence Appeal Tribunal, arguing that chronic back pain and psychological injuries removed him from the MIG.

The Tribunal found that the applicant's physical injuries were predominantly soft tissue sprains and strains, and there was no compelling evidence of significant functional impairment or psychological injury.

The Tribunal also found the respondent provided sufficient medical reasons for its denials.

Consequently, the applicant's injuries were deemed minor, subject to the $3,500 funding limit, and the disputed treatment plans, interest, and award claims were dismissed.

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

The respondent insurer denied certain benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant's injuries were predominantly soft tissue injuries subject to the MIG, and that he failed to establish any pre-existing condition that would impede his recovery.

The Tribunal also dismissed the applicant's claims for non-earner benefits, finding no evidence of a complete inability to carry on a normal life, as well as claims for physiotherapy, emergency services expenses, and a special award.

The applicant was injured in a motor vehicle accident and submitted a treatment plan to the respondent insurer.

The respondent denied the plan, arguing it was unsigned and that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant submitted a valid treatment plan for $369.47.

Furthermore, the respondent failed to respond within the required 10 business days under section 38 of the Schedule.

As a result, the respondent was prohibited from taking the position that the applicant's impairment fell within the MIG and was ordered to pay the treatment plan costs along with accrued interest.

The applicant's claim for costs was dismissed.