23 total
Accident benefits appeal dismissed as applicant failed to prove injuries fell outside the Minor Injury Guideline.
The Applicant sought payment for three chiropractic treatment plans and non-earner benefits following a 2015 motor vehicle accident.
The insurer denied the claims on the basis that the Applicant's injuries fell within the Minor Injury Guideline (MIG) and were not reasonable and necessary.
The Tribunal found the Applicant lacked credibility due to inconsistent statements about his employment and failure to disclose a prior 2013 accident with similar injuries.
The Tribunal accepted the insurer's independent medical examinations, concluding the Applicant failed to prove his impairments were directly caused by the 2015 accident or that he met the test for non-earner benefits.
The appeal was dismissed entirely.
Application for accident benefits dismissed; applicant's injuries found to fall within the Minor Injury Guideline.
The applicant sought accident benefits following a motor vehicle accident, specifically claiming the cost of an attendant care assessment.
The insurer denied the claim on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The arbitrator found that the applicant failed to meet the onus of proving his impairments fell outside the MIG, preferring the insurer's expert evidence that the diagnosed radiculopathy was a sequelae of soft tissue injuries.
As the applicant was subject to the MIG, he was not entitled to attendant care benefits, rendering the assessment cost unreasonable and unnecessary.
The application was dismissed.
Accident benefits claim dismissed as injuries fell within the Minor Injury Guideline cap.
The Applicant claimed statutory accident benefits for medical treatment and examination costs following a motor vehicle accident.
The Insurer denied the claims on the basis that the Applicant's injuries fell within the Minor Injury Guideline (MIG) and she had exhausted the $3,500 cap.
The Applicant argued she suffered psychological impairments and required treatment outside the MIG.
The arbitrator found no objective evidence of psychological impairment or any pre-existing condition that would prevent maximal recovery within the MIG cap.
The arbitrator accepted the Insurer's expert evidence that the Applicant exaggerated her symptoms and that her physical injuries were minor.
The application for benefits was dismissed.
No co-appearing lawyers found.
No judges found.