Shannon Mulholland

The applicant sought a Non-Earner Benefit (NEB) following a motor vehicle accident, arguing entitlement strictly on the basis that the respondent insurer failed to provide proper medical reasons for its denial under s. 36(4) of the Statutory Accident Benefits Schedule.

The Tribunal found that the respondent's denial was valid and compliant, as it clearly stated the applicant was ineligible for a NEB because he qualified for an Income Replacement Benefit (IRB).

The Tribunal held that an insurer is not required to provide medical reasons for a denial if the denial is not based on medical grounds, nor must the reasons be legally correct to satisfy the notice requirements.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming his psychological impairments and soft tissue injuries warranted removal from the Minor Injury Guideline (MIG).

The respondent denied the benefits, arguing the injuries were predominantly minor.

The Tribunal found that the applicant failed to prove a psychological impairment, preferring the respondent's psychological assessment which indicated the applicant was 'faking bad' on validity testing.

The Tribunal also accepted the respondent's musculoskeletal assessment that the applicant sustained uncomplicated soft tissue injuries.

Consequently, the applicant remained within the MIG and was not entitled to the disputed treatment plans, interest, or an award for unreasonable delay.

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) and the $3,500 limit had been exhausted.

The applicant claimed to have suffered a concussion and chronic pain, which would warrant removal from the MIG.

The Tribunal found insufficient medical evidence to support a diagnosis of a concussion or chronic pain with functional impairment.

As the applicant failed to prove injuries outside the MIG, and the $3,500 limit was exhausted, the claims for various treatment plans and assessments were dismissed.

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

The applicant brought motions to admit late medical reports, which the Tribunal denied due to non-compliance with disclosure rules without sufficient explanation.

The respondent's request for costs regarding the motions was also denied.

On the substantive issues, the applicant argued his injuries should be excluded from the Minor Injury Guideline (MIG) due to a pre-existing bicep tear, chronic pain, and a concussion.

The Tribunal found the applicant failed to provide compelling medical evidence that his pre-existing condition prevented maximal recovery within the MIG limits.

The Tribunal also found the applicant did not meet the AMA Guides criteria for chronic pain and that his concussion-like symptoms were attributable to pre-existing vision issues rather than the accident.

Consequently, the applicant's injuries were deemed subject to the MIG, and his claims for additional medical benefits and interest were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to medical benefits and examination costs for psychological, neurological, and chronic pain assessments.

The respondent denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and raised causation issues, attributing her symptoms to a pre-existing multiple sclerosis (MS) condition.

The Tribunal found that the applicant's physical and psychological complaints were largely attributable to her pre-existing MS, which was not aggravated by the accident.

The Tribunal concluded that the applicant failed to establish a psychological impairment, concussion, or chronic pain that would warrant removal from the MIG.

Consequently, the disputed treatment plans were deemed not reasonable and necessary, and the application was dismissed.

The appellants constructed a detached garage on their property pursuant to a building permit issued by the respondent municipality.

During construction, the appellants accessed an unopened road allowance (Ninth Street).

After completion, the respondent took the position that access via Ninth Street was not permitted and blocked the street with concrete barriers.

The appellants sued seeking removal of the barriers, an easement, or damages for breach of promissory estoppel and negligent misrepresentation, plus punitive damages.

The trial judge dismissed all claims.

The Court of Appeal upheld the dismissal, finding no merit in the appellants' arguments regarding negligence, promissory estoppel, negligent misrepresentation, or punitive damages.

The applicant sought statutory accident benefits for a driver anxiety assessment and a hydrotherapy program following a motor vehicle accident.

The Tribunal found that while the insurer's initial denial of the driver anxiety assessment was defective for failing to provide medical reasons, the defect was cured by a subsequent letter.

Because the applicant had not incurred the expense during the defective notice period, the insurer was not obligated to pay.

The Tribunal further held that neither the driver anxiety assessment nor the hydrotherapy program were reasonable and necessary, as the medical evidence did not support their effectiveness.

The application was dismissed.

The applicant, who was injured in a motor vehicle accident, sought statutory accident benefits for social worker support, an in-home occupational therapy assessment, and travel costs for a service provider.

The Licence Appeal Tribunal found that the social worker support duplicated an already approved psychological treatment plan and was therefore not reasonable and necessary.

The Tribunal also found the in-home assessment was not reasonable and necessary based on independent medical examinations.

Finally, the Tribunal held that the Statutory Accident Benefits Schedule does not require insurers to pay travel costs for service providers.

The application was dismissed.

The applicant, who was 9 years old at the time of the motor vehicle accident, sought statutory accident benefits for social worker support, an in-home occupational therapy assessment, and travel costs for a service provider.

The Licence Appeal Tribunal dismissed the claims, finding that the social worker support duplicated an already approved psychological treatment plan, and the in-home assessment was not reasonable and necessary given the applicant's functional independence.

The Tribunal also held that the Statutory Accident Benefits Schedule does not mandate insurers to pay for the travel expenses of service providers.