The applicant sought statutory accident benefits following a motor vehicle accident.
The insurer denied several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
As a preliminary issue, the insurer argued the applicant was statute-barred from disputing a chiropractic treatment plan due to the two-year limitation period.
The Tribunal found the insurer's initial denial notice was defective under the Smith criteria, meaning the limitation period did not begin until a valid notice was later provided; thus, the claim was not statute-barred.
On the merits, the Tribunal held the applicant failed to prove her psychological impairments or chronic pain warranted removal from the MIG.
However, because the insurer failed to provide a valid denial notice within 10 business days for the first chiropractic treatment plan, it was required under s. 38(11) of the Schedule to pay for services incurred during the period of non-compliance.
All other treatment plans were denied, and the claim for a s. 10 award was dismissed.