Ramandeep Pandher

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

The insurer denied payment for psychological services, arguing the provider failed to comply with an information request, and denied two chiropractic treatment plans as not reasonable and necessary.

The Tribunal found it had jurisdiction over the psychological services dispute and ordered payment, finding the provider had sufficiently complied with the information request.

The Tribunal dismissed the claims for chiropractic services, finding the applicant's injuries had resolved.

The Tribunal also granted a 25% award under Regulation 664 against the insurer for unreasonably delaying payment of the psychological services invoice.

The applicant was injured in a motor vehicle accident and sought a medical benefit of $3,539.72 for a physiotherapy treatment plan, which the respondent insurer denied.

The Licence Appeal Tribunal found the treatment plan to be reasonable and necessary, relying on the applicant's consistent reports of pain and the recommendations of both the applicant's assessor and one of the respondent's own assessors that further therapy was warranted.

The Tribunal ordered the respondent to pay the benefit with interest, but denied the applicant's claim for an award under Ontario Regulation 664, finding no evidence that the respondent unreasonably withheld or delayed payments.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming for a chiropractic treatment plan and a hospital emergency room visit.

The respondent insurer denied the claims.

The Licence Appeal Tribunal found the chiropractic treatment plan to be reasonable and necessary, as it helped reduce pain and increase range of motion, despite the insurer's medical reports suggesting otherwise.

However, the Tribunal denied the claim for the hospital visit, finding the applicant failed to prove it was directly related to the accident.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and several medical and rehabilitation treatment plans.

The Licence Appeal Tribunal found that the applicant failed to meet the burden of proving a complete inability to carry on a normal life, noting a lack of detailed evidence regarding pre- and post-accident activities.

The Tribunal also dismissed the claims for medical benefits, preferring the respondent's orthopaedic assessment over the applicant's treating chiropractor, and finding the applicant's evidence insufficient to establish that the treatments were reasonable and necessary.

The application was dismissed in its entirety, and the applicant's request for costs was denied.

The applicant requested a reconsideration of a Tribunal decision denying her non-earner benefits.

She argued the Tribunal erred by addressing the Minor Injury Guideline (MIG), which was not in dispute, and by failing to consider her reply submissions.

The respondent also requested reconsideration to correct the denial date and remove the MIG findings.

The adjudicator acknowledged errors in addressing the MIG and missing the reply submissions.

However, the adjudicator found that considering the reply submissions would not have changed the outcome, as they only addressed procedural fairness and not the substantive medical evidence.

The request to vary the decision on non-earner benefits was denied, but the findings regarding the MIG were removed.

The applicant was injured in a rear-end motor vehicle accident and sought Non-Earner Benefits (NEB) under the Statutory Accident Benefits Schedule.

The respondent denied the NEB, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and she did not suffer a complete inability to carry on a normal life.

The Tribunal found that the applicant's injuries were predominantly soft tissue injuries falling within the MIG.

Relying on Independent Medical Examinations and the applicant's family physician's clinical notes, the Tribunal concluded the applicant failed to meet the burden of proving a complete inability to carry on a normal life.

The application for NEB and interest was dismissed.

The applicant was injured in a motor vehicle accident and sought medical benefits for physiotherapy, a chronic pain assessment, and psychological services under the Statutory Accident Benefits Schedule.

The respondent insurer denied the benefits, relying on its own medical assessors and questioning the credibility of the treatment providers.

The Tribunal found the clinical notes and records of the applicant's treating family physician and psychologist to be comprehensive and persuasive, establishing that the disputed treatment plans were reasonable and necessary.

The applicant was awarded all disputed benefits with interest, but no costs were awarded to either party.

The applicant was injured in a rear-end motor vehicle accident and sought attendant care and medical benefits.

The adjudicator found the applicant was statute-barred from claiming attendant care benefits because the application was filed beyond the two-year limitation period.

Furthermore, the adjudicator determined the applicant's injuries fell within the Minor Injury Guideline (MIG) based on medical evidence and self-reporting, and that she had exhausted the $3,500 limit for medical and rehabilitation benefits.

All claims for additional treatment, assessments, and interest were dismissed.

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

The respondent denied a treatment plan for physiotherapy, chiropractic, and massage therapy, relying on an insurer's examination that placed the applicant's injuries within the Minor Injury Guideline (MIG), despite having previously removed the applicant from the MIG.

The Tribunal found the treatment plan reasonable and necessary.

The Tribunal also approved the outstanding $200 for a psychological assessment, finding the difference in estimated hours insignificant.

The applicant was awarded interest on overdue payments but denied an award under Regulation 664, as there was insufficient evidence of bad faith or unreasonable delay by the respondent.

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

The insurer denied various medical, rehabilitation, attendant care, and non-earner benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant failed to meet the burden of proving her injuries warranted removal from the MIG, noting that her medical evidence was unpersuasive and internally contradictory.

Furthermore, the applicant's claim for non-earner benefits was dismissed because her own statements to independent examiners demonstrated she had resumed a significant portion of her pre-accident activities.

The appeal was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits, attendant care benefits, and medical benefits for chiropractic and occupational therapy services.

The Licence Appeal Tribunal denied the non-earner benefits, finding the applicant did not suffer a complete inability to carry on a normal life as he could still perform some pre-accident activities, albeit with pain.

The Tribunal granted attendant care benefits of $404.90 per month, preferring the applicant's occupational therapy assessment over the insurer's examination.

The Tribunal also approved the chiropractic treatment plan as reasonable and necessary but denied the occupational therapy plan.

Interest was awarded on overdue payments, but both parties' requests for costs were denied.

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident that occurred while he was working.

The respondent insurer refused to pay, arguing the applicant failed to provide evidence of his election not to claim WSIB benefits and failed to report his pre-accident income to the Canada Revenue Agency.

The Licence Appeal Tribunal dismissed the application, finding the applicant was non-compliant with the insurer's requests for information for over four years.

Furthermore, pursuant to section 4(5) of the Schedule, the applicant's IRB quantum was zero because he had not reported his employment income in accordance with the Income Tax Act.

Claims for a special award and interest were also dismissed.

The applicant was injured in a motor vehicle accident and sought ongoing income replacement benefits (IRBs) and payment for various medical/rehabilitation treatment plans and assessments after the respondent insurer terminated them.

The Tribunal found that the applicant's radiculopathy and disc herniation were caused by the accident, rejecting the insurer's argument of an intervening event.

The Tribunal concluded the applicant met both the pre-104 week and post-104 week tests for IRBs, establishing a complete inability to engage in suitable employment.

However, the applicant failed to meet her burden to prove that the disputed treatment plans and assessments were reasonable and necessary.

The application was granted in part, with ongoing IRBs awarded.