William Robinson Brennan

The applicant sought statutory accident benefits five and a half years after a motor vehicle accident.

The insurer denied the claims and argued the application was time-barred.

The Tribunal held the applicant was not barred from proceeding because the insurer failed to advise her that she could be permanently disentitled if she did not provide a reasonable explanation for the delay.

The Tribunal also found the insurer failed to provide notice within 10 days that it was relying on the Minor Injury Guideline (MIG), meaning it could not rely on the MIG limit and had to pay for physiotherapy incurred during the default period.

However, the Tribunal dismissed the claims for psychological services and prescription medication, finding the applicant failed to prove they were reasonable and necessary or temporally connected to the accident.

The appellant appealed a Licence Appeal Tribunal decision that found his injuries from a motor vehicle accident fell within the Minor Injury Guideline (MIG) and denied two treatment plans for assessments.

The Divisional Court held that the adjudicator made no error of law and reasonably concluded that the appellant failed to meet his burden of proving entitlement to benefits beyond the MIG cap.

The appeal was dismissed.

The applicant sought accident benefits following a motor vehicle accident but failed to attend a pre-hearing discussion and the subsequent arbitration hearing.

The applicant's counsel sought to be removed from the record but was denied for failing to comply with Rule 9.7 of the Dispute Resolution Practice Code.

As the applicant failed to appear and presented no evidence to support her claims, the application for arbitration was dismissed without costs.

The applicant sought a medical benefit of $1,482.00 for a physiotherapy treatment plan following a motor vehicle accident.

The respondent denied the plan based on an insurer examination which concluded the treatment was not reasonable and necessary.

The adjudicator found that the applicant's back and neck injuries were pre-existing and not accident-related.

Furthermore, the proposed treatment was substantially similar to previous physiotherapy that had worsened the applicant's condition.

The application was dismissed and no interest was payable.

The insurer applied for a determination of whether s. 45 of the Statutory Accident Benefits Schedule requires an insured to identify a single accident when applying for a catastrophic impairment designation.

The insured had been involved in three motor vehicle accidents and submitted a single OCF‑19 application claiming catastrophic impairment based on the cumulative effects of all three accidents.

The court interpreted the legislation and regulatory scheme and concluded that the catastrophic impairment determination must be anchored to a single identified accident.

However, the insured may still rely on the cumulative impact of prior accidents where the specified accident represents the tipping point leading to catastrophic impairment.

The court therefore granted the application in part and declared that the application must specify one accident.