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Insurer ordered to pay medical, transportation, and housekeeping benefits, plus a $5,000 special award.
The applicant was injured in a motor vehicle accident and sought various statutory accident benefits that the insurer had terminated or denied.
The arbitrator found that the applicant's ongoing chiropractic and massage therapy treatments were reasonable for pain relief, and that her physical and cognitive limitations justified the cost of taxi transportation to treatment sessions and ongoing housekeeping expenses.
However, the claim for opioid prescription medication was denied, as the weight of medical opinion indicated it was not beneficial and potentially harmful.
The arbitrator rejected the applicant's argument that her income replacement benefits should include the indexation percentage for the first year following the onset of disability, finding the statutory language clear.
Finally, the arbitrator ordered the insurer to pay a $5,000 special award for unreasonably withholding payment for treatments and medication in blatant disregard of the pay-pending-dispute provisions of the Schedule.
Income replacement benefits awarded for a closed period due to psychological impairment; other claims dismissed.
The applicant was injured in a motor vehicle accident and received income replacement benefits for 104 weeks.
The insurer terminated benefits, and the applicant sought ongoing income replacement, attendant care, and housekeeping benefits.
The arbitrator found that the applicant did not suffer a complete inability to engage in suitable employment due to physical injuries, but did suffer such an inability due to psychological complications (severe depression and anxiety) until her condition stabilized.
The arbitrator awarded income replacement benefits for a closed period.
The claims for attendant care and housekeeping expenses were dismissed because the applicant failed to prove she incurred a cost or obligation to pay her husband for those services.
Claims for statutory accident benefits dismissed due to significant inconsistencies and credibility issues in applicants' evidence.
The applicants sought statutory accident benefits, including income replacement, education, rehabilitation, and medical benefits, following a motor vehicle accident.
The insurer terminated benefits and the matter proceeded to arbitration.
The arbitrator dismissed the applicants' claims, finding significant inconsistencies and credibility issues in their evidence regarding the accident and their injuries.
The arbitrator also found the medical and rehabilitation evidence unreliable.
The insurer's request for expenses and a special award for frivolous claims was also dismissed, as the arbitrator accepted an accident occurred and did not find the claims to be an abuse of process.
No co-appearing lawyers found.
No judges found.