5 total
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and medical benefits for physiotherapy, psychological assessment, and chiropractic services.
The respondent denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and that he did not suffer a complete inability to carry on a normal life.
The Tribunal found that the applicant's physical and psychological injuries were predominantly minor and subject to the MIG limit, which had already been exhausted.
The Tribunal also found that the applicant failed to prove a complete inability to carry on a normal life, as he had returned to substantially all of his pre-accident activities.
The application was dismissed.
Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from the Minor Injury Guideline.
The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits from the respondent insurer.
The insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the treatment plans were not reasonable and necessary.
The Licence Appeal Tribunal found that the applicant's physical injuries were predominantly minor and that she failed to prove on a balance of probabilities that she suffered from chronic pain or a psychological impairment that would warrant removal from the MIG.
As the applicant had exhausted the $3,500 MIG limit, the application for further benefits and interest was dismissed.
Application for accident benefits dismissed; applicant failed to prove chronic pain or psychological impairments to escape MIG.
The applicant sought medical and rehabilitation benefits following a motor vehicle accident.
The respondent insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued that chronic pain and psychological impairments removed him from the MIG.
The Tribunal found that the applicant failed to provide compelling medical evidence of functional impairment from chronic pain or a psychological impairment, preferring the respondent's s. 44 psychological assessment.
As the applicant's injuries were predominantly minor and the MIG funding was exhausted, the application for further benefits and interest was dismissed.
Income replacement benefits denied as applicant failed to prove substantial inability to perform employment tasks.
The applicant sought income replacement benefits following a motor vehicle accident.
The respondent denied the benefits based on independent medical examinations.
The Tribunal found that the applicant failed to prove she suffered a substantial inability to perform the essential tasks of her pre-accident employment.
The evidence indicated that the applicant's periods of unemployment were due to temporary layoffs rather than accident-related impairments, and she had actively sought and obtained other employment.
Income replacement benefits granted but attendant care, housekeeping, and medical benefits denied due to unreliable evidence.
The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement, attendant care, housekeeping, and medical benefits.
The insurer denied the claims, arguing the accident did not occur as described and the applicant was untruthful.
The arbitrator found the applicant proved the accident occurred and was entitled to income replacement benefits due to a substantial inability to perform his pre-accident employment.
However, the claims for attendant care, housekeeping, and medical benefits were dismissed due to insufficient, unreliable, and exaggerated evidence.
The applicant was awarded interest on overdue payments, and both parties were ordered to bear their own arbitration expenses.
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