Dr. Burke

The applicant sought non-earner benefits following a motor vehicle accident, claiming a complete inability to carry on a normal life.

The applicant had a significant pre-accident medical history, including fibromyalgia, which had previously rendered her unable to work.

The Tribunal reviewed medical evidence, including insurer examinations and surveillance footage, which demonstrated that the applicant was able to engage in most of her pre-accident activities of daily living.

The Tribunal found that the applicant's ongoing impairments were largely attributable to her pre-existing conditions and dismissed the application for non-earner benefits.

The applicant was injured in a motor vehicle accident and sought a non-earner benefit and various medical and rehabilitation benefits from her insurer.

The arbitrator dismissed the claim for a non-earner benefit, finding that the applicant's pre-existing fibromyalgia and medical history contradicted her assertion that she suffered a complete inability to carry on a normal life as a result of the accident.

However, the arbitrator awarded several medical benefits, including palliative treatments, household aids, and a stair lift, finding them reasonable and necessary to address the pain and difficulties caused by the accident.

Claims for a vibration machine and an assistive bed were denied.

The applicant was awarded $30,000 in expenses.

The insurer appealed a preliminary arbitration order that refused to stay or adjourn the main hearing after the insured refused to attend requested neuropsychological and psychiatric examinations.

The Director's Delegate dismissed the appeal regarding the neuropsychological assessment, finding the insurer's late request amounted to trial brinkmanship.

However, the appeal was allowed regarding the psychiatric examination.

The Director's Delegate found the insurer acted reasonably and without undue delay in requesting the psychiatric assessment after new medical evidence suggested a mood disorder, and ordered the hearing adjourned if the insured failed to attend.