Dr. C. Osinga

The applicant sought payment for orthopaedic and psychological assessments following a motor vehicle accident.

The respondent denied the assessments, and the applicant argued the denial was untimely under section 38(8) of the Statutory Accident Benefits Schedule.

The Tribunal found that while the denial was late, the applicant had not incurred the costs prior to receiving notice of the denial.

The Tribunal held that the applicant was barred from adjudicating the psychological assessment due to a failure to attend a properly scheduled section 44 insurer's examination.

Furthermore, the orthopaedic assessment was found not to be reasonable and necessary.

Claims for a special award under Regulation 664, interest, and costs were all dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including non-earner, attendant care, housekeeping, and medical benefits.

The arbitrator found significant credibility issues with the applicant's evidence, noting inconsistencies and symptom magnification.

The claims for non-earner and housekeeping benefits were dismissed as the applicant failed to establish a complete or substantial inability to perform his pre-accident activities.

Attendant care benefits were granted for a limited one-month period.

The arbitrator also awarded the cost of an attendant care assessment, one treatment plan, and a special award due to the insurer's unreasonable delay in paying for the assessment.