Sareena Harpreet Samra

The applicant was injured in a motor vehicle accident and sought accident benefits, including removal from the Minor Injury Guideline (MIG), Income Replacement Benefits (IRBs), and approval of several treatment plans.

The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from a psychological impairment or chronic pain with functional impairment that would warrant removal from the MIG.

The Tribunal also found that the applicant was not entitled to IRBs, as the evidence indicated he returned to work shortly after the accident and was later laid off due to a shortage of work, rather than an inability to perform his essential tasks.

As the applicant remained within the MIG, the disputed treatment plans were not considered.

The application was dismissed.

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

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

The applicant applied to the Licence Appeal Tribunal, arguing for removal from the MIG based on psychological impairment and chronic pain.

The Tribunal found insufficient medical evidence to support either a psychological injury or chronic pain condition resulting from the accident.

As the applicant remained within the MIG and the funding limit was exhausted, the disputed treatment plans were not considered.

The claims for an award and interest were also dismissed.

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

The respondent denied three chiropractic treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG due to chronic pain and psychological impairment.

The Tribunal found insufficient evidence of functional impairment from chronic pain or a psychological diagnosis to warrant removal from the MIG.

As the applicant remained within the MIG limit, the disputed treatment plans were not payable, and claims for interest and a section 10 award were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including treatment plans for chiropractic, physiotherapy, and psychological services, as well as medication expenses.

The Licence Appeal Tribunal found that the applicant failed to prove the chiropractic and physiotherapy plans were reasonable and necessary, as they lacked corroborating medical evidence.

However, the Tribunal approved the unapproved balances for several psychological treatment plans, finding them supported by the family doctor's clinical notes and records.

The claims for medication and a special award under s. 10 of O. Reg. 664 were dismissed.

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

The Tribunal found the applicant's injuries were predominantly minor and subject to the $3,500 Minor Injury Guideline (MIG) limit, as the applicant failed to provide compelling medical evidence of a pre-existing condition or psychological impairment warranting removal.

A treatment plan for physical therapy was denied because the MIG limit was exhausted.

However, the Tribunal ordered the respondent to pay for a $2,200 psychological assessment once incurred, finding the respondent's denial was defective under s. 38(8) of the Schedule because it relied on an unrelated, previously settled claim, thereby triggering the 'shall pay' provision.

Claims for a special award under s. 10 of Reg. 664 were dismissed as the respondent's error was not highhanded or unreasonable.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that his injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found the applicant failed to prove a psychological impairment warranting removal from the MIG, placing little weight on a psychological report based solely on self-reporting.

Claims for income replacement benefits were dismissed due to a lack of supporting medical evidence.

The Tribunal ordered the insurer to pay $200.00 for an improperly deducted disability certificate fee, but denied the remaining treatment plans as the MIG limits were exhausted.

A claim for a bad faith award under s. 10 of Regulation 664 was also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to treatment plans for chiropractic services and a psychological assessment outside the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on a psychological condition and a potential concussion.

The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from a psychological condition or a concussion, relying on the family doctor's clinical notes and an insurer's examination that suggested malingering.

As the applicant remained within the MIG, the disputed treatment plans were not payable, and claims for an award and interest were dismissed.

The applicant sought payment for the unapproved balances of treatment plans for psychological services and an occupational therapy assessment following a motor vehicle accident.

The dispute centered on the hourly rate charged by a psychotherapist, which the applicant argued should match a psychologist's rate due to supervision and interpretive services provided.

The Tribunal found the applicant failed to prove the higher rate was justified by specialized training or experience.

The claims for the unapproved balances, interest, and an award under Regulation 664 were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits, physiotherapy, psychological services, and a psychological assessment.

The respondent denied the benefits.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove the treatment plans were reasonable and necessary.

The Tribunal also found the applicant did not suffer a complete inability to carry on a normal life, relying on independent medical examinations indicating the applicant continued to work and attend school without significant functional limitations.

Claims for interest and an award for unreasonable delay were also 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 applicant argued for removal from the MIG based on chronic pain and psychological injury.

The Tribunal found the applicant failed to establish chronic pain with functional impairment or a psychological condition warranting further investigation.

The application was dismissed, and the applicant was held to the MIG limits.

The applicant sought payment for unapproved amounts related to psychological services, an attendant care assessment, and catastrophic impairment assessments following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove the unapproved amounts were reasonable and necessary.

Specifically, the applicant did not justify paying a social worker at a psychologist's rate, failed to make submissions on the attendant care assessment, and did not establish that the denied catastrophic assessment fees were not a duplication of services.

The applicant sought a non-earner benefit and various medical and rehabilitation benefits following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant had not suffered a complete inability to carry on a normal life, as she continued to engage in her pre-accident activities of daily living.

The Tribunal also denied the disputed treatment plans for chiropractic, physiotherapy, and social work services, relying on the clinical notes of the applicant's family doctor and the respondent's section 44 insurer examinations, which indicated the treatments were not reasonable and necessary.

Claims for interest and a special award were consequently dismissed.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs), a psychological assessment, and physiotherapy services under the Statutory Accident Benefits Schedule.

The respondent denied the benefits.

The Tribunal found the applicant failed to prove a substantial inability to perform the essential tasks of his employment to qualify for IRBs, noting his second absence from work coincided with parental leave.

The Tribunal also found the applicant did not provide sufficient medical evidence to prove the proposed psychological assessment and physiotherapy services were reasonable and necessary.

The application was dismissed in its entirety.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule, which the respondent insurer denied.

The Licence Appeal Tribunal found the applicant was entitled to two treatment plans for chiropractic services, as the medical evidence supported her ongoing symptoms from an ankle fracture, and the insurer's expert reports were given little weight.

The Tribunal also approved the unapproved balance of two psychological treatment plans, preferring the treating psychologist's recommendation for 1.5-hour sessions over the insurer's expert's 1.0-hour recommendation.

However, the Tribunal denied a third psychological treatment plan because the applicant failed to attend a scheduled insurer's examination, barring her claim under s. 55(1)(2) of the Schedule.

Claims for travel expenses and an occupational therapy assessment were also dismissed due to insufficient evidence.

The Tribunal declined to order a special award under s. 10 of Reg. 664, finding the insurer's reliance on its expert reports was not unreasonable.

The applicant sought payment for the unapproved balance of a multidisciplinary catastrophic impairment assessment following a motor vehicle accident.

The respondent had approved the assessments up to the $2,000 per modality limit but denied additional fees for file reviews and transportation.

The Tribunal found that file review fees are an essential component of an assessment and are captured within the $2,000 funding limit.

The Tribunal also found that the applicant was not entitled to transportation expenses because she lived within the 50 km deductible radius and had withdrawn her claim for a catastrophic impairment determination.

The application was dismissed.

The applicant sought various statutory accident benefits following a motor vehicle accident, including costs for catastrophic impairment assessments, nursing home services, visitor expenses, and damaged clothing.

The Tribunal found that the applicant failed to meet his burden of proving entitlement to any of the claimed expenses.

The catastrophic assessment costs exceeded the $2,000 limit per assessment under section 25(5) of the Schedule, and insufficient evidence was provided to support the reasonableness and necessity of the other claimed expenses.

The application was dismissed in its entirety, along with claims for interest and a special award.

The applicant sought statutory accident benefits following a motor vehicle accident, including funding for physiotherapy, psychological services, and a psychological assessment.

The Tribunal found that the applicant failed to prove the physiotherapy treatment plan was reasonable and necessary due to insufficient medical evidence of ongoing physical pain.

While the psychological services and assessment were deemed reasonable and necessary, the Tribunal found they were not costed in accordance with the Professional Services Guideline.

The applicant failed to prove entitlement to the disputed hourly rates and hours claimed.

The application was dismissed.

The applicant sought various statutory accident benefits following a 2017 motor vehicle accident.

The Tribunal dismissed the claims for increased income replacement benefits, finding that 100% of the applicant's CPP-D benefits were properly deducted from the base amount.

Claims for treatment plans and housekeeping were also dismissed for lack of evidence.

However, the Tribunal found the applicant was entitled to attendant care benefits at the rates set out in the approved Form-1, despite the submitted invoices claiming higher rates.

The Tribunal also ordered a 10% award under s. 10 of Regulation 664, finding the insurer unreasonably withheld payment of the approved attendant care benefits after receiving sufficient documentation.

The applicant insurer sought repayment of $30,112.00 in income replacement benefits (IRBs) paid to the respondent insured, alleging she wilfully misrepresented her post-accident employment status.

The Tribunal found that the respondent was employed and received Employment Insurance benefits during the period she collected IRBs, and that she deliberately failed to disclose this income to the insurer.

Concluding that the respondent wilfully misrepresented her employment status, the Tribunal ordered her to repay $30,016.00 in IRBs to the applicant.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming the unapproved portions of several treatment plans for psychological and occupational therapy services.

The respondent had partially approved the plans but denied the higher hourly rate proposed for a psychotherapist and the costs for brokerage services.

The Tribunal found that the applicant failed to demonstrate why the psychotherapist should be paid at a rate equivalent to a psychologist, exceeding the Professional Services Guideline.

Furthermore, the applicant provided no evidence to justify the brokerage services, which are excluded under the Guideline.

The application was dismissed, and claims for interest and an award were denied.