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Application for accident benefits dismissed as applicant failed to prove injuries fell outside the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent insurer held that the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied several treatment plans.
The applicant applied to the Licence Appeal Tribunal, arguing her injuries warranted removal from the MIG due to chronic pain and psychological impairment.
The Tribunal found that the applicant failed to demonstrate injuries outside the MIG, preferring the respondent's insurer examination reports over the applicant's medical evidence, which lacked objective support and was inconsistent with clinical records.
The application was dismissed, and the applicant remained subject to the $3,500 MIG limit.
Accident benefits denied as applicant's injuries fell within the Minor Injury Guideline and limits were exhausted.
The respondent denied various treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.
The Tribunal found that the applicant failed to provide compelling evidence of a pre-existing psychological condition or chronic pain syndrome that would prevent maximal medical recovery within the MIG.
Relying on clinical notes, prescription records, and independent medical examinations, the Tribunal concluded the injuries were minor.
As the MIG limits were exhausted, the disputed treatment plans and interest were denied.
No co-appearing lawyers found.
No judges found.