The claimant sought reconsideration of the Tribunal’s decision which declined to remove the insurer’s counsel of record. The claimant argued that because the firm representing the insurer had also represented one of the defendants in the earlier tort action, a conflict existed. Vice Chair Helt concluded that the Tribunal did not make an error and dismissed the reconsideration. She noted that the counsel involved was different in each case, and that there was no evidence that any information was shared between counsel. Further, counsel representing the tort defendant no longer worked at the same firm.
Category: LAT Rules
The claimant requested reconsideration of a Motion Order, in which Vice Chair Hunter granted the respondent’s motion to adjourn a written hearing scheduled for December 2018. The claimant submitted that reconsideration was warranted because the Tribunal erred in granting an adjournment in respect of the addition of treatment plans when none were in issue, the decision gave rise to a reasonable apprehension of bias, and the delay in the proceeding had resulted in prejudice to the claimant. Associate Chair Batty denied the request for reconsideration, concluding that the claimant had failed to establish grounds for reconsideration. He ordered the parties to comply with the Vice Chair’s Order, noting that a party seeking a reconsideration has a high onus to meet and that inconsequential procedural or substantive errors do not qualify for reconsideration.
The claimant brought a motion for the production of log notes; the insurer brought a motion for productions of various clinical notes and records. Adjudicator Hines granted both motions. She ordered the log notes up to the date of the IRB denial to be produced subject to redactions for litigation privilege and solicitor-client privilege. She also ordered that the requested clinical notes and records were relevant and should be produced.
The claimant sought entitlement to two medical benefits. The claimant also sought to add a new medical benefits claim as part of a written hearing. Adjudicator Punyarthi permitted the issue to be added, but held that it was not payable because a treatment plan had never been submitted in relation to the incurred treatment. The two medical benefits for physical therapy that were originally part of the dispute were not awarded because the claimant failed to demonstrate that passive treatment was warranted for her injuries.
The claimant refused to produce various records sought by the insurer. The insurer brought a motion for production of the records. Adjudicator Ferguson held that all of the requested medical records that were requested by the insurer because they were relevant to the claimant’s injuries and his late application for accident benefits. The records showing when the claimant purchased insurance with another insurer was relevant in relation to the claimant’s late application for accident benefits as well.
The claimant had filed two LAT applications: one addressing NEBs and five treatment plans; the second addressing a catastrophic impairment determination. The claimant had exhausted her medical benefits and would only be entitled to the disputed treatment plans if she suffered a catastrophic impairment. A hearing was scheduled on the first application, while the second application had not yet gone through the Case Conference. The insurer sought an order that the treatment plans be removed from the first application because they could not be awarded until the catastrophic impairment determination was made. The Case Conference adjudicator denied the request. The insurer requested reconsideration, and Vice Chair Trojek also denied the request. Instead, she ordered that the scheduled hearing be adjourned and that the two LAT applications be combined so that all issues could be determined at once. She reasoned that approach was the most cost effective and just determination of all issues.
The insurer sought an adjournment of the scheduled Case Conference to allow time for CAT assessment to be completed. The Tribunal refused the requested. Associate Chair Batty also refused the adjournment request, stating that the assessments need to be completed by the time of the Case Conference for the insurer to participate. The insurer’s defence did not need to be finalized by the Case Conference, and the claim was not being adjudicated during the Case Conference.
A written hearing had been scheduled to address the claims for medical benefits and removal from the MIG. The claimant failed to comply with production orders and did not file her written submissions. The claimant failed to participate in a Case Conference resumption. Adjudicator Boyce dismissed the matter as abandoned.
The claimant had requested an adjournment of a written hearing due to her counsel’s unanticipated medical leave. The LAT refused the adjournment. On reconsideration, Vice Chair Trojek granted the adjournment and set new dates for the written hearing. She wrote that the Tribunal relied too heavily on a strict adherence with its rules and failed to take into consideration the unforeseen and uncontrollable circumstances which were supported by documentary evidence.
The insurer sought reconsideration of the Tribunal’s decision that the claimant could apply to the LAT to dispute a catastrophic impairment determination without any other benefits being in dispute. Vice Chair Flude rejected the insurer’s arguments and held that the Insurance Act permitted the Tribunal to hear the claimant’s dispute.