Elvis Viskovic

The applicant sought statutory accident benefits following a motor vehicle accident, claiming his injuries warranted removal from the Minor Injury Guideline (MIG) due to a concussion, psychological impairments, and pre-existing conditions.

The Tribunal found insufficient medical evidence to substantiate a concussion or any non-minor physical impairments.

The Tribunal gave little weight to the applicant's psychological report and preferred the respondent's section 44 assessment, which found no objective evidence of psychological impairment.

The Tribunal concluded the applicant's injuries were predominantly minor, dismissing the claims for a psychological assessment, an award for delayed payments, and interest.

The applicant sought payment for an activities of daily living assessment and an orthopaedic assessment following a motor vehicle accident.

The respondent argued the claims were statute-barred as they were disputed more than two years after being denied.

The Tribunal found the applicant was statute-barred from claiming the activities of daily living assessment because a clear and unequivocal denial had been issued more than two years prior.

However, the denial for the orthopaedic assessment was not clear and unequivocal.

The Tribunal ordered the respondent to pay for the orthopaedic assessment, finding the applicant had incurred the cost before receiving a valid denial and was compliant with section 44 of the Schedule.

The applicant sought statutory accident benefits for psychological treatment following a motor vehicle accident.

The insurer denied the treatment plan on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the insurer failed to provide notice of its denial within the required 10 business days under section 38(8) of the Schedule, and was therefore prohibited from relying on the MIG limit.

However, the Tribunal ultimately dismissed the application, finding that the applicant failed to prove on a balance of probabilities that the proposed psychological treatment was reasonable and necessary, as the objective medical evidence did not support a significant psychological impairment.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming costs for an orthopedic assessment and a treatment plan for physiotherapy and massage.

The respondent insurer denied the claims based on an insurer's examination (IE) by an orthopedic surgeon, who concluded the treatments were not reasonable or necessary.

The Licence Appeal Tribunal dismissed the appeal, finding the applicant failed to provide sufficient medical evidence to prove the treatment plans were reasonable and necessary, and accepted the respondent's IE report.

As no benefits were payable, the claim for interest was also dismissed.