Patrick Baker

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

The insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that a pre-existing psychological condition (Generalized Anxiety Disorder) removed him from the MIG.

The Tribunal found that the applicant failed to establish that his pre-existing condition was exacerbated by the accident or that he suffered physical injuries outside the MIG.

Consequently, the claims were subject to the $3,500 limit and the treatment plans were not payable.

The Tribunal also awarded $250 in costs to the insurer due to the applicant's late filing of expert reports and submissions.

The applicant, who was a passenger in a rear-end motor vehicle collision, applied for a non-earner benefit and a medical benefit for physiotherapy.

The adjudicator found that the applicant did not suffer a complete inability to carry on a normal life, noting that her post-accident activities, including attending college and working part-time, contradicted her claims of impairment.

The adjudicator also denied the medical benefit, relying on the insurer's independent medical examination reports which concluded the applicant had reached maximum medical recovery and found no objective medical evidence to support the need for further physiotherapy.

The application was dismissed in its entirety.

The respondent insurer requested a reconsideration of a Licence Appeal Tribunal decision that found the applicant was outside the Minor Injury Guideline (MIG).

The insurer argued the adjudicator misapplied the test for the pre-existing condition exception and improperly shifted the burden of proof.

The Associate Chair granted the reconsideration, finding that the adjudicator made a significant error by exempting the applicant from the MIG despite explicitly noting there was no compelling evidence, such as clinical notes and records, documenting a pre-existing condition that would prevent maximal recovery.

The original decision was set aside, and the applicant was found to be subject to the MIG.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for various treatment plans and assessments.

The insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline.

The Tribunal found that the applicant's chronic pain and the medical evidence supported that his injuries were not minor.

The Tribunal ordered the insurer to pay for four treatment plans for physical therapy and an orthopaedic assessment, finding them reasonable and necessary.

An in-home assessment was deemed incurred because the insurer unreasonably denied it without adequate medical reasons.

However, a cognitive assessment recommended by a chiropractor was denied as it was beyond the chiropractor's scope of practice and unsupported by psychological evidence.

The infant plaintiff suffered a severe head injury after falling from a balcony.

The plaintiffs sought to extend the time to set the action down for a non-jury trial to assess damages, while the defendant cross-moved to bifurcate the trial on liability and damages.

The master granted the bifurcation over the plaintiffs' objections, and the decision was upheld on appeal.

The plaintiffs appealed to the Divisional Court, arguing that Rule 6.1.01 of the Rules of Civil Procedure does not permit bifurcation of a non-jury trial without consent.

The majority of the Divisional Court dismissed the appeal, holding that Rule 6.1.01 did not abolish the court's inherent jurisdiction to bifurcate non-jury trials in exceptional cases without consent.

The respondent insurer filed a request for reconsideration of a preliminary decision more than 12 months after the 21-day deadline, arguing that its timely appeal to the Divisional Court demonstrated its intention to pursue a review.

The Tribunal declined to extend the deadline under section 7 of the Licence Appeal Tribunal Act or Rule 3, finding that allowing the late reconsideration would not promote an efficient or timely resolution and would prejudice the applicant who had already responded to the unsuccessful court appeal.

The request for reconsideration was dismissed.

The appellant insurer appealed an interlocutory decision of the Licence Appeal Tribunal (LAT) which found that the respondent's application for Income Replacement Benefits was not barred by the two-year limitation period.

The Divisional Court dismissed the appeal as premature, holding that appeals from administrative tribunals should generally be restricted to final decisions to avoid fragmentation and increased costs.

The insurer may raise the limitation period issue in an appeal of the final decision if unsuccessful on the merits.

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

The respondent denied a physiotherapy treatment plan on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the respondent's notice of denial was boilerplate and failed to provide sufficient medical reasons as required by section 38(8) of the Schedule.

Consequently, under section 38(11), the respondent was prohibited from taking the position that the MIG applied and was liable to pay the disputed benefit.

The applicant's claim for a special award was dismissed because the applicant had delayed disclosing a subsequent accident, meaning the respondent did not unreasonably withhold payment.

The appellant appealed an arbitrator's decision awarding the insurer $6,037.84 in arbitration expenses after the appellant withdrew his FSCO application to proceed at the Licence Appeal Tribunal.

The Director's Delegate dismissed the appeal, finding that the appellant raised new issues not before the arbitrator and that there was evidence to support the arbitrator's finding that the appellant's actions prolonged, obstructed, or unnecessarily hindered the proceedings.

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

The respondent denied income replacement benefits and medical benefits, arguing the applicant failed to attend a required section 44 insurer examination and that his injuries fell within the Minor Injury Guideline.

The Tribunal found the applicant was statute-barred under section 55(2) of the Schedule for failing to attend the scheduled ophthalmology examination.

In the alternative, the Tribunal found the applicant's injuries were predominantly minor, he had exhausted the Minor Injury Guideline limits, and he failed to establish a substantial inability to perform the essential tasks of his employment.

The applicant was injured in a rear-end motor vehicle collision and sought income replacement benefits (IRBs) from the respondent insurer.

The respondent terminated IRBs based on insurer's examinations.

The Tribunal found that the applicant's essential tasks of employment were sedentary and that the medical evidence did not support a substantial inability to perform those tasks.

The applicant's claims of physical and psychological impairments preventing work were contradicted by medical records and her ability to complete a post-secondary program.

The application for IRBs and interest was dismissed.

The applicant sought $2,909.47 for physiotherapy services following a motor vehicle accident.

The respondent denied the claim on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit under s. 18(1) of the Schedule had been reached.

The Tribunal found that the applicant failed to provide sufficient medical evidence to demonstrate that her injuries were not predominantly minor in nature.

The application was dismissed.

The applicant sought accident benefits following a motor vehicle accident, including a chronic pain assessment and chronic pain treatment.

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

The Licence Appeal Tribunal found that the applicant sustained predominantly minor soft tissue injuries, preferring the evidence of the insurer's orthopaedic surgeon and the applicant's own treating chiropractor over the applicant's chronic pain assessors.

As the injuries were deemed minor, the applicant was not entitled to the disputed treatment plans for chronic pain.

The applicant insurer sought judicial review of a FSCO Director's Delegate decision that allowed an insured's appeal in part regarding statutory accident benefits.

The insurer had denied claims for an in-home assessment and form preparation, alleging the clinics were engaged in a fraudulent scheme.

The Divisional Court held that the Director's Delegate exceeded his jurisdiction by interfering with the Arbitrator's findings of fact regarding the in-home assessment, as appeals are limited to questions of law.

However, the court upheld the decision requiring the insurer to pay for form preparation because the insurer failed to object to the application within the statutory timeframe.

The applicant, an Ontario resident, was injured in an ATV accident in British Columbia.

He applied for statutory accident benefits in Ontario.

The insurer denied the claim on the basis that the ATV was not an 'automobile' under the Statutory Accident Benefits Schedule because it was not required to be insured in British Columbia.

The applicant sought judicial review of the FSCO Director's Delegate's decision upholding the denial.

The Divisional Court dismissed the application, finding it was reasonable to apply British Columbia legislation to determine whether the ATV required insurance, and thus the ATV did not meet the definition of an automobile.

The applicant was injured in a motorcycle accident and sought payment for neurological, chronic pain, and orthopaedic assessments under the Statutory Accident Benefits Schedule.

The respondent denied the treatment plans.

The Licence Appeal Tribunal found that the chronic pain assessment was reasonable and necessary given the applicant's ongoing complaints of pain and stiffness.

However, the Tribunal dismissed the claims for neurological and orthopaedic assessments, finding insufficient medical evidence to support their necessity.

Claims for interest and costs were also dismissed.

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) until she returned to work.

The insurer sent a letter terminating the IRBs but stating she could submit an updated disability certificate if she had to leave work again due to her injuries.

More than two years later, the applicant filed an appeal for further IRBs after stopping work again.

The insurer raised a preliminary issue, arguing the appeal was statute-barred under s. 56 of the Statutory Accident Benefits Schedule.

The Tribunal found that the insurer's termination letter was not a clear and unequivocal denial, as it suggested her options remained open if her circumstances changed.

Therefore, the limitation period was not triggered, and the appeal was allowed to proceed.

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

The respondent denied a treatment plan for chiropractic services, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's injuries fell outside the MIG because the accident aggravated pre-existing injuries and materially contributed to the development of chronic pain syndrome.

However, the Tribunal dismissed the claim for the specific treatment plan, finding the applicant failed to prove it was reasonable and necessary given her lack of progress with similar past treatments.

The applicant sought a medical benefit of $4,124.88 for chiropractic services following a motor vehicle accident.

The respondent insurer initially denied the benefit under the Minor Injury Guideline, but later conceded the applicant was removed from the guideline based on a psychological assessment.

The adjudicator found that the applicant failed to provide objective medical evidence to prove the chiropractic treatment was reasonable and necessary, noting that her own treating physicians recommended physiotherapy rather than chiropractic care.

The application was dismissed, and the applicant's request for costs based on the insurer's alleged bad faith was denied.

The applicant sought payment for various medical and rehabilitation benefits following a motor vehicle accident.

The Licence Appeal Tribunal denied several out-of-pocket expenses because the applicant failed to submit a Treatment and Assessment Plan prior to incurring them, as required by section 38(2) of the Statutory Accident Benefits Schedule.

However, the Tribunal awarded $14,266.59 for prescription medications, finding they fell under the exception in section 38(2)(c)(i) and were reasonable and necessary to treat accident-related physical and psychological impairments.

The Tribunal also approved a chiropractic treatment plan aimed at pain reduction, while denying a physiotherapy plan that had previously shown no improvement.

Interest was awarded on the payable benefits.