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Application for statutory accident benefits dismissed as proposed treatment and assessment plans were not reasonable and necessary.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied several treatment and assessment plans, including chiropractic services, cognitive devices, a driving reintegration assessment, a chronic pain assessment, and a fitness membership assessment.
The Tribunal found that the applicant failed to prove on a balance of probabilities that the proposed plans were reasonable and necessary, preferring the respondent's section 44 examination reports which found no objective evidence of impairment and concluded the applicant had reached maximal medical recovery.
The application was dismissed.
Application for accident benefits dismissed; applicant failed to prove chronic pain warranting removal from MIG.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming her injuries fell outside the Minor Injury Guideline (MIG) due to chronic pain with a functional impairment.
The Licence Appeal Tribunal reviewed the medical evidence, including assessments from both the applicant and the insurer.
The Tribunal found the applicant's evidence of chronic pain uncompelling, preferring the insurer's assessments which indicated normal range of motion and minor sprain/strain injuries.
The Tribunal concluded the applicant did not suffer from chronic pain with a functional impairment, remained subject to the MIG, and was therefore not entitled to the disputed treatment plans or interest.
Medical benefits partially granted; one treatment plan statute-barred for failure to attend insurer's examination.
The applicant sought statutory accident benefits for physiotherapy, chiropractic treatment, and the cost of completing an OCF-18 following a motor vehicle accident.
The Tribunal found the $2,495.48 treatment plan reasonable and necessary to assist in the applicant's recovery.
However, the $3,260.64 treatment plan was dismissed as the applicant was statute-barred under s. 55 for failing to attend an insurer's examination.
The claim for the cost of completing the OCF-18 was also dismissed as it did not meet the criteria under s. 25(1)3.
The Tribunal declined to order an award under s. 10 of O. Reg. 664, finding no evidence that the insurer acted in bad faith.
No co-appearing lawyers found.
No judges found.