Patrick Poupore

The applicant sought payment for various treatment plans, including occupational therapy, psychological and orthopaedic assessments, and workplace modification devices, following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant failed to establish on a balance of probabilities that the proposed treatment plans were reasonable and necessary.

Medical evidence indicated the applicant had reached functional recovery and returned to pre-accident activities without accommodations.

The application was dismissed.

The applicant sought resolution of a dispute regarding the hourly rate at which Attendant Care Benefits (ACB) would be paid, despite the insurer having approved the submitted Form 1s in full.

The insurer raised a preliminary issue arguing the Licence Appeal Tribunal lacked jurisdiction under s. 280 of the Insurance Act because there was no live dispute over entitlement or the amount of the benefit.

The Tribunal agreed, finding that since the insurer approved the ACB in full and there was no denial, there was no dispute within the meaning of s. 280.

The application was dismissed for lack of jurisdiction.