Serena Gohal

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 the applicant failed to prove on a balance of probabilities that he sustained a shoulder tear caused by the accident or that his pre-existing conditions warranted removal from the MIG under s. 18(2) of the Schedule.

The Tribunal also dismissed the claim for income replacement benefits, finding the applicant failed to provide sufficient evidence of his inability to perform the essential tasks of his employment.

The application was dismissed.

The applicant requested a reconsideration of a previous Licence Appeal Tribunal decision that denied her claims for an Income Replacement Benefit (IRB) and various treatment plans following a motor vehicle accident.

The applicant argued the Tribunal erred in law by requiring her to prove IRB entitlement after finding an accident occurred, and by not assessing whether the treatment plans were reasonable and necessary.

The Tribunal dismissed the reconsideration request, finding no error of law, as the applicant failed to meet her evidentiary burden for the IRB and the treatment plans were not incurred.

The plaintiff brought a motion to restore a motor vehicle accident lawsuit to the trial list, while the defendants moved to dismiss the action for delay.

The court found that although there was a significant delay of nearly ten years since the statement of claim was issued, the active delay was primarily caused by the defendants and court administration issues rather than the plaintiff.

Additionally, the court determined that the defendants failed to demonstrate any non-compensable prejudice that would prevent a fair trial.

Consequently, the court granted the plaintiff's motion to restore the action and dismissed the defendants' motion to dismiss for delay.

The applicant sought statutory accident benefits following an incident where she was assaulted by her husband while driving, causing her to veer off the road and mount a curb.

The Tribunal found that the incident met the definition of an "accident" under s. 3(1) of the Schedule, as the operation of the vehicle was the dominant feature causing her psychological injuries, which exacerbated pre-existing conditions.

Consequently, the applicant's injuries were removed from the Minor Injury Guideline.

However, the applicant's claims for an income replacement benefit, various treatment plans, attendant care benefits, and a special award were dismissed because she failed to provide sufficient medical evidence or establish that the expenses were reasonable, necessary, and incurred.

The applicant sought $19,097.00 for a multidisciplinary catastrophic impairment assessment following a 2012 motor vehicle accident.

The respondent insurer denied the treatment plan, arguing the applicant sustained only minor soft tissue injuries and had a significant pre-existing medical history.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to provide corroborating medical evidence to support the necessity of the assessments or justify their costs, particularly given the $2,000 cap per assessment under section 25(5)(a) of the Schedule.

The appellant was assaulted by her husband while driving, causing her to lose control of the vehicle and strike her head.

She applied for statutory accident benefits.

The Licence Appeal Tribunal found the incident was not an 'accident' because the assault was an intervening act and the dominant feature of the injuries.

On appeal, the Divisional Court held that the adjudicator erred in law by failing to consider the incident in two phases: the assault itself, and the subsequent loss of control of the vehicle.

The appeal was allowed in part, and the issue of whether the injuries from the loss of control constituted an accident was remitted for a hearing.

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

The applicant argued the Tribunal made an error of law or fact by failing to properly apply the causation test and the dominant feature test.

The Tribunal dismissed the request, finding that the applicant was attempting to re-argue her case and introduce new arguments not raised at the initial hearing.

The Tribunal concluded no error of law or fact was made.

The applicant sought a non-earner benefit and a medical benefit for an occupational therapy assessment following a motor vehicle accident.

The Tribunal found that the applicant failed to establish a complete inability to carry on a normal life, noting inconsistent effort and embellishment during insurer's examinations.

The Tribunal preferred the insurer's expert reports over the applicant's psychological assessment, which failed to compare pre- and post-accident functioning.

The application was dismissed, and the applicant was not entitled to the claimed benefits or interest.

The applicant sought statutory accident benefits after sustaining injuries when her husband assaulted her while she was driving, causing her to lose control of the vehicle and hit a curb.

The respondent insurer raised a preliminary issue of whether the incident constituted an 'accident' under section 3(1) of the Statutory Accident Benefits Schedule.

The Tribunal applied the two-part purpose and causation test, finding that while the purpose test was met, the causation test was not.

The Tribunal concluded that the assault was an intervening act and the dominant feature of the injuries, breaking the chain of causation from the use or operation of the automobile.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits, as well as the cost of several assessments, which the respondent insurer denied.

The Licence Appeal Tribunal found that the applicant was entitled to the cost of a top cover foam mattress, chiropractic, physiotherapy, and massage services, and an orthopaedic assessment, as these were reasonable and necessary for her recovery.

However, the Tribunal dismissed the claims for a psychological assessment and an occupational therapy assessment, finding them unnecessary given prior assessments and a lack of supporting evidence.

The applicant was also awarded interest on overdue payments.

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

The insurer denied a treatment plan for physiotherapy, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit was exhausted.

The Tribunal found the applicant failed to prove on a balance of probabilities that his injuries fell outside the MIG, noting a lack of evidence linking ongoing pain to the accident and a significant gap in treatment.

The Tribunal also found the insurer provided valid denials under s. 38(8) of the Schedule.

The application was dismissed.

The applicant sought a determination that she sustained a catastrophic impairment due to a mental or behavioural disorder following a motor vehicle accident.

The adjudicator applied the three-step approach from Pastore and found that while the accident caused a mental or behavioural disorder, the impact on the applicant's life was limited.

Preferring the respondent's medical experts who noted symptom exaggeration and validity concerns, the adjudicator concluded the applicant was only mildly impaired and did not meet the threshold for catastrophic impairment.

The application was dismissed.