Sonya M. Katrycz

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

The respondent denied the benefits on the basis that the applicant had exhausted her non-catastrophic policy limits and had not been determined to be catastrophically impaired.

The Tribunal held that the application for benefits was premature, as the applicant could not be entitled to further benefits without a catastrophic impairment designation.

The claims for benefits were dismissed without prejudice.

However, the Tribunal allowed the applicant to proceed to a hearing on her standalone claim for an award under Regulation 664.

The respondent's request for costs was dismissed.

The applicant insurer sought repayment of $48,628.57 in Income Replacement Benefits (IRB) paid to the respondent, alleging the benefits were paid due to wilful misrepresentation and fraud.

The respondent failed to participate in the written hearing or comply with Tribunal orders to produce employment and income records.

The Tribunal drew an adverse inference from the respondent's non-compliance and relied on surveillance evidence showing the respondent working as a manual labourer while claiming IRB.

The Tribunal ordered the respondent to repay the full amount of the IRB plus interest pursuant to section 52 of the Statutory Accident Benefits Schedule.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits and a treatment plan for physiotherapy.

The applicant failed to provide any written submissions or evidence by the deadlines imposed by the Tribunal, despite being afforded multiple opportunities.

The Tribunal dismissed the application, finding the applicant failed to meet his evidentiary burden.

The respondent's request for costs was denied, as the applicant's failure to provide submissions did not rise to the high threshold required for a costs award.

The applicant requested a reconsideration of a Tribunal decision that found her accident-related impairments fell within the Minor Injury Guideline (MIG) and denied her claims for an income replacement benefit (IRB) and various treatment plans.

The applicant argued the Tribunal made errors of fact and law, failed to provide sufficient reasons, and violated procedural fairness.

The Vice-Chair dismissed the request, finding no errors in the original adjudicator's assessment of the insurer's notices, the substantive denial of the IRB, or the handling of preliminary evidentiary issues.

The Vice-Chair also rejected the applicant's allegations of bias and advocacy by the original adjudicator.

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

The insurer determined her injuries fell within the Minor Injury Guideline (MIG) and denied funding for physiotherapy and occupational therapy beyond the $3,500 limit.

The Tribunal found that the applicant had sustained a head injury, removing her from the MIG.

However, the Tribunal dismissed the claims for the disputed treatment plans, finding the applicant failed to prove they were reasonable and necessary.

The claim for an award under Regulation 664 was also dismissed, as there was insufficient evidence of unreasonable delay or bad faith by the insurer.

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

The respondent denied a physiotherapy treatment plan on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been exhausted.

The applicant argued he suffered from chronic pain, removing him from the MIG.

The Tribunal found the applicant's medical evidence, including clinical notes from his family doctor and a chiropractor's disability certificate, insufficient to establish chronic pain.

The Tribunal concluded the injuries were minor and, as the respondent had already paid $3,590 in benefits, the MIG limit was exhausted and the treatment plan was denied.

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits, which the insurer denied on the basis that her injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that while the applicant's physical injuries were predominantly minor, she demonstrated on a balance of probabilities that she suffers from chronic pain syndrome with a psychological component, warranting removal from the MIG.

The Tribunal ordered payment for one physiotherapy treatment plan, psychological assessment and treatment, and prescription expenses, finding them reasonable and necessary to address her chronic pain.

The remaining treatment plans and assessments were denied as redundant or unnecessary, and the claim for a special award was dismissed as the insurer had a genuine dispute.