Peter Durant

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

The matter proceeded to a written hearing, but the applicant failed to file any submissions or evidence after their representative withdrew.

Pursuant to section 7(2) of the Statutory Powers Procedure Act, the Tribunal proceeded in the applicant's absence.

The Tribunal found that the applicant failed to meet their burden of proof to demonstrate removal from the Minor Injury Guideline or entitlement to the claimed benefits.

The application was dismissed.

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

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

The Tribunal found that the applicant did not suffer from a psychological injury, chronic pain, or a pre-existing condition that would warrant removal from the MIG.

Consequently, the applicant was subject to the $3,500 funding limit and was not entitled to the disputed treatment plans, interest, or an award.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, which the respondent insurer denied.

The respondent raised a preliminary issue, arguing the applicant was barred from proceeding with his application before the Tribunal under section 55 of the Schedule for failing to fully participate in neuropsychological and psychological insurer's examinations under section 44.

The Tribunal found that the applicant had attended the examinations, though he did not complete all tasks.

Crucially, the Tribunal held that the respondent's notices for further psychological examinations were deficient because they failed to provide adequate medical or other reasons for the repetitive assessments.

Consequently, the respondent could not rely on section 55 to bar the application, and the applicant was permitted to proceed.

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

The Tribunal found the applicant was removed from the Minor Injury Guideline due to a concussion diagnosis supported by medical evidence.

The applicant was awarded several treatment plans, including chiropractic services, psychological assessments, and a post-concussion syndrome workshop, as they were deemed reasonable and necessary.

The Tribunal also found the applicant entitled to pre-104 week income replacement benefits, as he suffered a substantial inability to perform the essential tasks of his employment as a heavy machine operator.

However, claims for post-104 week income replacement benefits, an award for unreasonable delay, and costs were dismissed.

The applicant requested a reconsideration of a preliminary issue decision which found she was not involved in an 'accident' under the Schedule.

She argued the Tribunal breached procedural fairness by refusing to admit her affidavit evidence, and erred in law by failing to apply binding caselaw and by considering her tort Statement of Claim.

The Tribunal dismissed the request, finding no breach of procedural fairness because the applicant had previously consented to an order stating no affidavits would be filed.

The Tribunal also found no error of law, as the caselaw was either considered or distinguishable, and the Statement of Claim was properly admitted as evidence of her perspective on the incident.

The applicant sought an income replacement benefit (IRB) following a motor vehicle accident.

The applicant did not attend the hearing.

The core issue was whether the applicant properly responded to a request for further information under s. 36(4)(c) of the Statutory Accident Benefits Schedule.

The Tribunal found that the respondent validly requested further information via fax to the applicant's representative, despite the lack of a cover letter.

Because the applicant failed to comply with the request for information, s. 33(6) was triggered, and the IRB was not payable.

The application was dismissed.

The applicant sought statutory accident benefits after slipping and falling on ice while allegedly attempting to enter her husband's vehicle.

The respondent denied benefits on the basis that the incident was not an 'accident' under s. 3(1) of the Schedule.

At a preliminary issue hearing, the Tribunal applied the two-part test from Caughy.

While the purpose test was met, the causation test failed because the slip and fall on the ice constituted an intervening act that broke the chain of causation.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits and medical benefits for psychological services and driving counselling.

The Licence Appeal Tribunal found that the applicant did not meet the test for non-earner benefits, as she was not continuously prevented from engaging in substantially all of her pre-accident activities.

The Tribunal denied the balance of the psychological treatment plan because the proposed hourly rate exceeded the appropriate rate for a psychotherapist.

However, the Tribunal partially approved the treatment plan for driving counselling to address the applicant's driving anxiety, awarding $898.28 plus interest.

The applicant sought payment for chiropractic, occupational therapy, and social work treatment plans following a motor vehicle accident.

The respondent insurer denied the plans based on insurer's examinations concluding the applicant had no accident-related impairments.

The Tribunal found that the applicant failed to meet his onus to prove the treatments were reasonable and necessary, noting a lack of contemporaneous medical evidence and failure to disclose medical records.

The application for accident benefits was dismissed.

The insurer sought repayment of $280,447.35 in income replacement benefits (IRB) paid to the insured, alleging wilful misrepresentation regarding her receipt of long-term disability benefits.

The insured failed to participate in the Tribunal proceedings.

The Tribunal found that the insured's failure to disclose her long-term disability status and refusal to communicate with the insurer constituted wilful misrepresentation.

As a result, the 12-month limitation period for seeking repayment did not apply.

The Tribunal ordered the insured to repay the full amount of the IRB overpayment plus interest.

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

The respondent insurer determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied a treatment plan for optometric services.

The applicant applied to the Licence Appeal Tribunal.

The Tribunal found that the applicant failed to demonstrate that his double vision and blurry vision were caused by the accident, as medical evidence attributed the symptoms to dry eyes.

Consequently, the applicant remained subject to the MIG's $3,500 limit.

However, pursuant to section 40(8) of the Schedule, the disputed treatment plan was deemed reasonable and necessary up to the remaining MIG balance of $631.27.

The appellant appealed a decision of the Licence Appeal Tribunal denying her claims for various statutory accident benefits following a motor vehicle accident.

The appellant argued the insurer failed to properly manage her request for a catastrophic impairment designation.

The Divisional Court dismissed the appeal, finding the adjudicator correctly concluded that the issue of catastrophic impairment was not properly before the tribunal because the appellant had not initiated a claim or provided an evidentiary basis for it.

The court found no errors of law in the adjudicator's decision.

The applicant sought statutory accident benefits for optometric assessments and services following a rear-end motor vehicle accident.

The insurer denied the treatment plans based on an independent medical examination by a neuro-ophthalmologist, who concluded the applicant's vision issues were age-related presbyopia rather than accident-related impairments.

The Tribunal applied the 'but for' test for causation and preferred the evidence of the insurer's neuro-ophthalmologist over the applicant's optometrist and physiatrist due to his specialized medical training.

The Tribunal found the treatment plans were not reasonable and necessary, and dismissed the application.

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

A four-day hearing was scheduled, but the applicant and their counsel failed to attend.

After the hearing commenced in their absence pursuant to section 7 of the Statutory Powers Procedure Act, the Tribunal was informed that a Notice of Withdrawal had been filed shortly after the scheduled start time.

The Tribunal noted the lack of civility in failing to attend to advise of the withdrawal, but closed the file as the application was withdrawn.

The applicant requested a reconsideration of a previous decision that denied her entitlement to an attendant care benefit, an income replacement benefit, various treatment plans, an award, and costs.

The applicant alleged multiple errors of law and fact, including the Tribunal's failure to consider certain statutory provisions and rules, and sought damages for bad faith.

The Adjudicator dismissed the request, finding that the applicant failed to establish any grounds for reconsideration under Rule 18.2 and was instead attempting to re-argue her case.

The self-represented applicant sought various statutory accident benefits, including attendant care benefits, income replacement benefits, and medical/rehabilitation benefits, following a 2017 motor vehicle accident.

The Tribunal found that the applicant failed to meet her burden of proving that the claimed benefits were reasonable and necessary, as she focused her arguments on unsupported allegations against the respondent and assessors rather than presenting substantive evidence.

The application was dismissed in its entirety, and the Tribunal declined to award costs to either party, noting that while the applicant's conduct was resource-intensive, it was not vexatious or in bad faith.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied his claims for various medical and rehabilitation benefits, including vocational retraining, medical marijuana, assistive devices, and a gym membership.

The applicant argued the adjudicator made errors of fact and law in weighing the medical evidence.

The Tribunal dismissed the request, finding that the applicant was merely attempting to re-argue his position and reweigh the evidence, which does not meet the criteria for reconsideration under Rule 18.2(b) of the Common Rules.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that partially denied her claims for treatment plans under the Statutory Accident Benefits Schedule.

The applicant argued that the Tribunal violated procedural fairness by refusing to consider her late reply submissions and by asking factual questions after the hearing.

She also alleged errors of law regarding the application of the Minor Injury Guideline and claimed there was new evidence.

The Vice-Chair dismissed the request, finding no procedural unfairness as the applicant missed the mandated deadline for reply submissions.

The Vice-Chair also found no error of law, noting the applicant was attempting to reargue her case, and concluded that the applicant failed to identify any new evidence that met the test for reconsideration.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits, including vocational training, medical marijuana, assistive devices, a gym membership, and rehabilitation therapy.

The respondent insurer denied the benefits on the basis that they were not reasonable and necessary.

The Licence Appeal Tribunal found that the applicant failed to meet his burden of proving that any of the disputed treatment plans were reasonable and necessary, noting discrepancies between the applicant's self-reporting to his family doctor and the assessors.

The claims for benefits, interest, and an award for unreasonable delay were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's denial of several treatment plans (OCF-18s) and an expense for a mouth guard.

The Tribunal found that the insurer properly denied a $3,696.50 chiropractic treatment plan under s. 38(5) of the Schedule because the applicant was subject to the Minor Injury Guideline at the time.

The Tribunal partially approved a physiotherapy treatment plan for $199.50, finding it reasonable and necessary based on the recommendation of a chronic pain specialist.

The remaining treatment plans and expenses were dismissed as the applicant failed to discharge her evidentiary onus to demonstrate they were reasonable and necessary.

Interest was awarded on the overdue payment.