9 total
Applicant subject to Minor Injury Guideline; failed to prove pre-existing polio prevented recovery within limits.
The applicant sought accident benefits following a motor vehicle accident, arguing she should be removed from the Minor Injury Guideline (MIG) due to a pre-existing condition involving partial paralysis from childhood polio.
The Licence Appeal Tribunal found the applicant failed to provide compelling medical evidence from a treating practitioner that her pre-existing condition would prevent her from achieving maximum medical recovery within the MIG.
Relying on the insurer's examination report, the Tribunal concluded the applicant's injuries were predominantly minor.
As the applicant was subject to the MIG and the limits were not exhausted, the disputed treatment plans for chiropractic services and the claim for interest were denied.
Tribunal partially awards medical benefits and attendant care entitlement but denies income replacement benefits.
The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits, attendant care benefits, and various medical and rehabilitation benefits.
The respondent argued the applicant was barred from proceeding on certain issues due to non-attendance at insurer's examinations.
The Tribunal found the applicant had a reasonable explanation for non-attendance due to the respondent's failure to provide previous examination reports.
On the merits, the Tribunal dismissed the claim for income replacement benefits, finding the applicant returned to her pre-accident part-time work level.
The Tribunal found the applicant entitled to attendant care benefits of $612.75 per month, but they were not payable as they had not been incurred.
Several treatment plans for assessments and assistive devices were partially approved, while claims for psychological treatment, an award, and costs were dismissed.
Tribunal denied attendant care and most treatment plans but granted spinal decompression therapy for accident-related injuries.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the respondent insurer.
The applicant claimed entitlement to attendant care benefits and several treatment plans, including occupational therapy, physiotherapy, spinal decompression therapy, and various assessments.
The Tribunal found that the applicant did not meet the burden of proving entitlement to attendant care benefits, as the medical evidence indicated functional range of motion and independence in self-care tasks.
The Tribunal also denied the claims for occupational therapy, physiotherapy, and the neurological and chronic pain assessments, either because the applicant failed to provide sufficient submissions or because the insurer's denials were compliant with the Schedule.
However, the Tribunal granted the claim for spinal decompression therapy, finding it reasonable and necessary based on a physician's recommendation supported by objective diagnostic imaging.
The applicant was also awarded interest on the overdue payment.
Application for statutory accident benefits largely dismissed as treatment plans were not proven reasonable and necessary.
The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of multiple treatment and assessment plans, medication expenses, and parking costs.
The Tribunal found that the applicant failed to prove on a balance of probabilities that the proposed in-home, attendant care, neurological, concussion, chiropractic, physiotherapy, and psychological plans were reasonable and necessary, preferring the objective findings of the respondent's assessors over the subjective reporting relied upon by the applicant's assessors.
The Tribunal awarded the cost of one prescription medication and interest on overdue payments, but denied the remaining expenses and the claim for a special award under s. 10 of Reg. 664.
Application for accident benefits dismissed because the applicant failed to attend scheduled insurer examinations.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent insurer denied benefits and scheduled insurer examinations under section 44 of the Schedule.
The applicant failed to attend the scheduled assessments and did not provide a reasonable explanation.
The Tribunal found that the notices of assessment were proper and provided sufficient medical reasons.
Consequently, the applicant was barred from proceeding with his claim under section 55 of the Schedule.
The application was dismissed, and the respondent's request for costs was denied.
Application for statutory accident benefits dismissed due to applicant's failure to attend the hearing.
The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit.
The applicant failed to attend the scheduled videoconference hearing despite the Tribunal providing proper notice and making reasonable efforts to contact him.
As the applicant did not participate or present any evidence, he failed to meet his burden of proof to establish entitlement to the claimed benefits.
The application was dismissed.
Applicant's chronic pain removes her from the Minor Injury Guideline; non-earner benefits and treatment plans granted.
The applicant was injured in a rear-end motor vehicle collision and sought statutory accident benefits.
The respondent insurer denied further treatment and non-earner benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant's injuries fell outside the MIG due to chronic pain syndrome, relying on the applicant's credible testimony and the evidence of a chronic pain specialist.
Applying the Heath framework, the Tribunal also found the applicant suffered a complete inability to carry on a normal life and awarded non-earner benefits.
The disputed treatment plans for physiotherapy and a chronic pain assessment were deemed reasonable and necessary and were approved with interest.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits.
The respondent denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued that a flap tear in his knee and a pre-existing condition removed him from the MIG.
The Tribunal found that a flap tear is a partial tear and falls within the definition of a minor injury.
The Tribunal also found no compelling evidence that the applicant's pre-existing condition was worsened by the accident or impeded his recovery.
The Tribunal concluded that the applicant sustained predominantly minor injuries, and since the $3,500 MIG limit was exhausted, the application for further benefits was dismissed.
Broker denied commission after failing to disclose dual agency before presenting offer.
A real estate brokerage sought commission after the seller refused to complete a residential sale despite entering an agreement of purchase and sale.
The seller argued the brokerage was not entitled to commission because its agent failed to disclose an existing buyer agency relationship with the purchasers before presenting the offer, contrary to the listing agreement and fiduciary duties.
The court held that the agent failed to make the required written disclosure of the dual agency relationship prior to presenting the offer.
This non‑disclosure constituted a material breach of the listing agreement and the agent’s fiduciary obligations.
As a result, the brokerage was disentitled from recovering commission under the agreement.