6 total
Accident benefits claim dismissed and $400 overpayment repayment ordered due to applicant's failure to participate.
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 matter proceeded to a written hearing, but the applicant failed to file any submissions or evidence after her representative withdrew.
The Tribunal found the applicant failed to meet her burden to prove her injuries warranted removal from the MIG or that she was entitled to the disputed treatment plans.
Additionally, the Tribunal ordered the applicant to repay $400.00 in income replacement benefits, as she had returned to work during the period for which the benefits were paid and the respondent had provided proper notice of the overpayment.
Reconsideration request dismissed as the applicant failed to demonstrate an error of law or fact.
The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied certain treatment plans and a claim for a special award following a motor vehicle accident.
The applicant argued the Tribunal erred in its assessment of the evidence regarding psychological, medical, and occupational therapy services.
The Vice-Chair dismissed the request, finding that the applicant was attempting to re-litigate the original decision and re-weigh the evidence rather than demonstrating a material error of law or fact under Rule 18.2.
The request for a special award was also dismissed as there was no evidence of excessive or imprudent conduct by the insurer.
Tribunal partially grants accident benefits for a stress assessment and cleaning supplies but denies other treatment plans.
The applicant sought entitlement to statutory accident benefits following a motor vehicle accident, disputing the insurer's denial of several treatment plans and expenses.
The Licence Appeal Tribunal found the applicant was entitled to a $2,000 medical services plan for a stress assessment and $15.24 for Swiffer refills, as these were proven reasonable and necessary.
The Tribunal dismissed the claims for the remaining psychological, occupational therapy, and medical services plans, finding the applicant failed to demonstrate how the goals of those plans would be met or why the costs were reasonable.
The applicant was awarded interest on overdue payments, but the claim for a section 10 award was dismissed as the insurer's conduct was not unreasonable.
Application for accident benefits dismissed; injuries fell within Minor Injury Guideline and no entitlement to NEB/IRB.
The insurer approved benefits within the Minor Injury Guideline (MIG) but denied further requests, including income replacement benefits (IRB), non-earner benefits (NEB), and a chronic pain assessment.
The Tribunal found the applicant's injuries were predominantly minor and she failed to establish chronic pain or psychological impairment to warrant removal from the MIG.
The claims for IRB and NEB were dismissed due to lack of evidence, procedural defects, and failure to meet the test for a complete inability to carry on a normal life.
The application was dismissed.
Arbitration application dismissed because third-party service providers lack standing under the Insurance Act.
A third-party health care service provider commenced an arbitration application in the name of the insured person, seeking payment of an outstanding account of $53,021.62.
The insured person had previously settled all claims with the insurer on a full and final basis.
The insurer brought a motion to dismiss the application on the basis that the service provider lacked standing.
The Arbitrator granted the motion, finding that the dispute resolution process under the Insurance Act is restricted to disputes between insured persons and insurers, and third-party service providers do not have standing to commence arbitration proceedings.
Unreasonable summary judgment motion attracted substantial indemnity costs.
This costs endorsement followed an unsuccessful third-party summary judgment motion seeking dismissal of a third party claim arising from a motor vehicle accident.
The court held that, in the post-Hryniak environment, substantial indemnity costs under Rule 20.06 may be awarded where a party acts unreasonably in bringing or responding to a summary judgment motion, without requiring egregious or reprehensible conduct.
The motion was found unreasonable because its legal basis was misplaced and the evidentiary record disclosed conflicting evidence requiring a trial.
The successful responding defendants were awarded substantial indemnity costs of $6,497.50 inclusive of HST.
