Dr. Derby

The applicant sought statutory accident benefits for occupational therapy services and devices following a motor vehicle accident.

The respondent denied the benefits on the basis that the treatment plans were not reasonable and necessary.

The Tribunal found that the applicant failed to prove the treatment plans were reasonable and necessary, preferring the evidence of the respondent's occupational therapist whose findings were consistent with other assessors.

The Tribunal also found the respondent's denials were valid and dismissed the claims for interest and an award for unreasonable delay.

The applicant sought payment for a neurocognitive assessment, a psychological assessment, and various other expenses following a motor vehicle accident.

The Licence Appeal Tribunal found that the neurocognitive assessment was reasonable as it was intended to help the applicant decide whether to bring a claim for catastrophic impairment, but capped the payable amount at $2,000 plus tax.

The claims for the psychological assessment and other expenses were dismissed, as the applicant failed to prove they were reasonable and necessary, and the medical evidence provided by the applicant was found to be inconsistent and lacking credibility.

The applicant was injured in a motor vehicle accident in 2008 and sought ongoing income replacement benefits, housekeeping benefits, and medical benefits for psychological treatment.

The insurer terminated benefits, relying on surveillance evidence and medical assessments indicating the applicant's condition had improved and he was exaggerating symptoms.

The arbitrator found the applicant's evidence lacked credibility, noting he failed to disclose a subsequent 2010 accident to assessors and attributed impairments from the second accident to the first.

The application for arbitration was dismissed, as the applicant failed to prove a complete inability to engage in suitable employment or a substantial inability to perform housekeeping tasks.