The applicant was injured in a motor vehicle accident and sought payment for a chiropractic treatment plan and a chronic pain assessment under the Statutory Accident Benefits Schedule.
The insurer denied the benefits.
The Licence Appeal Tribunal found that the insurer's denial of the chiropractic treatment plan failed to comply with the notice requirements under section 38(8) of the Schedule, making the benefit payable.
The Tribunal also found the chronic pain assessment was reasonable and necessary given the applicant's consistent pain complaints and medical history.
The applicant's request for a special award was denied as the insurer's reliance on its medical assessors did not constitute unreasonable withholding of benefits.
