Oleh Vereshchak

The applicant was injured in a motor vehicle accident in 2007 and sought payment for a physical therapy treatment plan proposed in 2014.

The insurer denied the claim based on an insurer's examination which concluded that the applicant had already received appropriate facility-based treatment and required no further treatment.

The Licence Appeal Tribunal found that the applicant's medical evidence was outdated and insufficient to prove that the proposed treatment was reasonable and necessary seven years post-accident.

The application for the medical benefit was dismissed.

The applicant was injured in a motor vehicle accident and received no-fault weekly income benefits from the insurer, as well as disability income benefits from a third-party group policy.

The third-party insurer deducted income tax at source and remitted the net amount to the applicant.

The insurer deducted the gross amount of the disability benefits when calculating the applicant's no-fault benefits.

The applicant disputed this, arguing only the net amount should be deducted.

The arbitrator held that the gross amount of the disability benefits is a payment 'available to the insured person' under Section 12(4)(b)(i) of the No-Fault Benefits Schedule and is therefore deductible in full.