Yu Jiang

The appellant appealed a Licence Appeal Tribunal reconsideration decision that barred her application for statutory accident benefits due to late notice.

The appellant argued the Tribunal erred in law in interpreting the notice requirements under the Statutory Accident Benefits Schedule.

The Divisional Court dismissed the appeal, finding that the issues raised regarding the limitation period and the reasonableness of the delayed notice were questions of mixed fact and law, which fall outside the court's statutory jurisdiction to hear appeals on questions of law only.

The court also noted the appellant improperly raised new arguments not advanced before the Tribunal.

The applicant, a 15-year-old pedestrian, was struck by a slow-moving vehicle and sought statutory accident benefits, including a non-earner benefit (NEB), medical and rehabilitation benefits, and the cost of a catastrophic impairment assessment.

The insurer denied the benefits.

The Tribunal found that the applicant was not entitled to the NEB, as she failed to prove that her accident-related injuries continuously prevented her from engaging in substantially all of her pre-accident activities, noting she successfully completed high school and transitioned to university.

The Tribunal partially approved the physiotherapy and psychological treatment plans, finding them reasonable and necessary, but denied transportation costs.

The request for a catastrophic impairment assessment was dismissed due to a lack of supporting medical evidence indicating a reasonable apprehension of catastrophic impairment.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for two chiropractic treatment plans, which the respondent insurer denied.

The insurer argued the applicant's injuries fell within the Minor Injury Guideline and that further facility-based treatment was not reasonable and necessary, suggesting a home exercise program instead.

The Tribunal found that the applicant's chronic pain and psychological diagnoses, including Somatic Symptom Disorder, supported the need for the treatment.

The Tribunal concluded both treatment plans were reasonable and necessary and awarded the claimed amounts plus interest.

The applicant sought income replacement benefits and a determination that her injuries fell outside the Minor Injury Guideline following a minor parking garage collision.

The adjudicator held that the characterization of injuries cannot be a standalone issue when no medical benefits are in dispute.

The claim for income replacement benefits was dismissed because the applicant failed to provide compelling evidence of disability, while the respondent's insurer examinations persuasively indicated symptom magnification and no accident-related impairment.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, the cost of a psychological assessment, and a plastic surgery consultation fee.

The Licence Appeal Tribunal dismissed the claims.

The Tribunal found the applicant did not suffer a complete inability to carry on a normal life, as evidence showed he maintained independence and returned to school and work.

While the psychological assessment was deemed reasonable and necessary, it was not payable because the cost had not been incurred.

The plastic surgery consultation fee was denied because it was incurred before a treatment plan was submitted.

The applicant sought medical and rehabilitation benefits following a motor vehicle accident.

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's physical injuries were soft-tissue in nature and that there was insufficient evidence of chronic pain or psychological impairment to warrant removal from the MIG.

As the MIG limits had been exhausted, the disputed treatment and assessment plans were deemed not reasonable and necessary.

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

The respondent denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that chronic pain and psychological impairments, including Adjustment Disorder and Specific Phobia, warranted removal from the MIG.

The Tribunal found that the physical injuries were soft-tissue in nature and that the applicant failed to provide sufficient medical evidence of functionally-disabling chronic pain or a diagnosable psychological impairment that would prevent maximal medical recovery within the MIG.

As the MIG limits were exhausted, the disputed treatment and assessment plans were deemed not reasonable and necessary, and the application was dismissed.

The applicant was injured in a motor vehicle accident and sought a non-earner benefit and medical benefits under the Statutory Accident Benefits Schedule.

The respondent denied the benefits, placing the applicant in the Minor Injury Guideline.

The Tribunal found the Minor Injury Guideline issue premature as no treatment plans were in dispute.

The Tribunal dismissed the claim for a non-earner benefit, finding the applicant failed to provide evidence comparing his pre- and post-accident activities to establish a complete inability to carry on a normal life as required by the Heath test.

The applicant was injured in a motor vehicle accident and sought medical, rehabilitation, and non-earner benefits from the respondent insurer.

The insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant contended that psychological impairments and chronic pain removed him from the MIG.

The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from psychological impairments or chronic pain caused by the accident.

The Tribunal concluded the injuries were predominantly minor and treatable within the MIG.

Furthermore, the applicant was not entitled to a non-earner benefit as he did not suffer a complete inability to carry on a normal life, nor was the proposed chiropractic treatment reasonable and necessary.

The applicant was injured in a motor vehicle accident and sought non-earner benefits and medical and rehabilitation benefits from the respondent insurer.

The Tribunal found that the applicant did not suffer a complete inability to carry on a normal life, as her pain did not practically prevent her from engaging in her pre-accident activities, and dismissed the claim for non-earner benefits.

However, the Tribunal found that several of the disputed treatment plans for physiotherapy, chiropractic, acupuncture, and massage services were reasonable and necessary to treat her lingering pain.

The applicant was awarded the approved medical benefits along with interest on overdue amounts.