Shannon M. Mulholland

Shannon acted as co-counsel on behalf of the respondent. The plaintiff sought unobstructed use of an unopened road allowance abutting his home. The insured had passed a by-law restricting use of motor vehicles on unopened road allowances. The claim was defeated at trial and upheld on appeal, allowing the insured municipality to keep blocks in place protecting its unopened road allowance from unauthorized use.

Shannon successfully defended the insurer against claims made for medical benefits. The applicant sought the cost of an assessment for driver anxiety and the cost of a medical benefit for a hydrotherapy program. The applicant asserted that the respondent did not validly deny the treatment plans and that the applicant was entitled to payment of both treatment plans as they were reasonable and necessary.

Shannon successfully distinguished the applicant’s case from the seminal case of General Accident Assurance Co. of Canada v. Violi, on the basis that the applicant’s goals of pain relief and improvement in her medical condition were not being met with continued passive treatment. The LAT agreed that an insurer is not required to continue to fund passive treatment that is not established as effective.

Further, the LAT agreed with the respondent that the insurer’s defective notice was “cured” by a subsequent denial and the insurer was not obliged to fund the OCF-18.

In these concurrent hearings, the minor applicants were brothers involved in a serious motor vehicle accident. Each application was decided independently on its own merits with respect to disputed rehabilitation benefits including social worker support, an in-home occupational therapy assessment, and travel costs of a service provider associated with an approved treatment plan. Shannon successfully defended the insurer against both applications.

The respondent had denied claims for social worker support on the basis of duplication. The respondent argued that the proposed social worker support had the same goals and therapeutic approach as psychological treatment which had already been approved. It was held that the insurer was not obliged to pay for treatment plans that had the same goals and methods.

The respondent had also denied treatment plans for in-home occupational therapy assessments. The applicants did not meet the onus of proof in demonstrating that the disputed assessments were reasonable and necessary, in particular with respect to the goals of overcoming at-home barriers to maximum medical recovery.

Further, the LAT agreed with the respondent that the insurer is not mandated by law to pay mileage pursuant to Bulletin No. A-14/14, even where the insurer is paying for the provider’s travel time.