3 total
Application for accident benefits dismissed; injuries found to fall within the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant failed to prove her injuries, including alleged chronic pain and psychological impairments, warranted removal from the MIG.
Consequently, the disputed treatment plans, which exceeded the $3,500 MIG limit, were not payable.
Claims for interest and a section 10 award were also dismissed.
Application for accident benefits dismissed as applicant failed to prove injuries warranted removal from the MIG.
The applicant sought statutory accident benefits following a motor vehicle accident but was denied by the respondent on the basis that her injuries fell within the Minor Injury Guideline (MIG).
The applicant argued she should be removed from the MIG due to chronic pain and psychological impairments.
The Tribunal found the medical evidence, including clinical notes and psychological assessments, did not support removal from the MIG.
The Tribunal also found the respondent's denial notices complied with section 38 of the Schedule.
The application was dismissed.
Tribunal removes applicant from Minor Injury Guideline due to concussion, granting chiropractic and neurological benefits.
The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's denial of treatment plans for chiropractic services, an occupational therapy assessment, and neurological assessments.
The insurer argued the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found the applicant suffered a concussion and ongoing impairments, removing her from the MIG.
The Tribunal granted the chiropractic treatment plans and one neurological assessment, finding them reasonable and necessary, but denied the occupational therapy assessment and a second neurological assessment due to lack of evidence or duplication.
Interest was awarded on the overdue benefits.