Shane LeRoux

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

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

The Tribunal found that the applicant's psychological injuries, including post-traumatic stress disorder and major depressive disorder, took him outside the MIG.

The Tribunal ordered the respondent to pay for the disputed psychological and physical treatment plans, as well as the cost of a psychological assessment, finding them reasonable and necessary.

The applicant's claim for a special award for unreasonably delayed payments was dismissed due to lack of evidence.

Following a successful arbitration where the insurer prevailed on all issues, the insurer sought expenses of over $17,000.

The arbitrator found the claimed preparation time and written argument time to be excessive given the lack of complexity and the short duration of the hearing.

Applying a lower ratio of preparation to hearing time and a reduced hourly rate, the arbitrator ordered the applicant to pay $3,700 in expenses, inclusive of disbursements and HST.

The insurer's request for the costs of the expense submissions was denied.

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

The Insurer denied several treatment plans and assessments, arguing the Applicant's injuries fell within the Minor Injury Guideline (MIG).

The arbitrator found that the Applicant's psychological and orthopaedic expert reports were tainted by a conflict of interest, as the primary psychologist had a close personal and financial relationship with the Applicant, and other experts relied on her clinic's flawed assessments.

The arbitrator excluded or gave no weight to the Applicant's expert evidence and accepted the Insurer's independent medical examinations.

The arbitrator concluded the injuries were predominantly minor and dismissed the claims for further benefits.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement, housekeeping, and attendant care benefits.

The insurer terminated these benefits based on insurer examinations.

The arbitrator found that the applicant remained substantially unable to perform the essential tasks of his pre-accident employment, noting the insurer failed to properly adjust the file when advised the applicant had not returned to work.

The arbitrator awarded income replacement benefits, partial housekeeping and attendant care benefits, and a $5,000 special award against the insurer for unreasonably withholding benefits.