3 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.
The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.
The applicant argued she should be removed from the MIG due to chronic pain and psychological impairments.
The Tribunal found that the applicant failed to prove on a balance of probabilities that she suffered from chronic pain with functional impairment or a psychological injury caused by the accident that would warrant removal from the MIG.
The Tribunal preferred the respondent's medical and psychological assessments.
As the MIG limit was exhausted, the claims for treatment plans and interest were dismissed.
Application for accident benefits dismissed; applicant failed to prove chronic pain or psychological injuries for MIG removal.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits.
The respondent insurer denied treatment plans for psychiatric, social work, and chronic pain assessments on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant applied to the Licence Appeal Tribunal, arguing for removal from the MIG due to chronic pain and psychological injuries.
The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from chronic pain or psychological injuries caused by the accident, preferring the insurer's expert evidence over the applicant's.
As the applicant's injuries did not fall outside the MIG and the $3,500 funding limit was exhausted, the application was dismissed.
Applicant removed from Minor Injury Guideline due to chronic pain; disputed treatment plans found reasonable and necessary.
The respondent insurer denied the claims, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and were subject to the $3,500 limit.
The Tribunal found that the applicant suffered from chronic pain and psychological impairments that caused functional disability, removing him from the MIG.
The Tribunal concluded that all disputed treatment plans, including chiropractic services, psychological services, and various assessments, were reasonable and necessary.
The applicant was awarded the claimed benefits and interest on overdue payments.
No co-appearing lawyers found.
No judges found.