3 total
Applicant's injuries found to be predominantly minor; removal from Minor Injury Guideline denied.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied various physiotherapy and psychological treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant failed to establish that a pre-existing knee condition or a psychological impairment warranted removal from the MIG.
As the applicant's injuries were predominantly minor, the disputed treatment plans were not reasonable and necessary, and no interest was payable.
Application for income replacement benefits dismissed; applicant failed to prove inability to work.
The applicant sought statutory accident benefits, including an income replacement benefit (IRB) and medication expenses, following a motor vehicle accident.
The respondent denied the benefits and argued the applicant was statute-barred for missing insurer's examinations.
The Tribunal found the applicant was not statute-barred as she attended rescheduled examinations.
However, the Tribunal dismissed the substantive claims, finding the applicant failed to prove a substantial or complete inability to perform the essential tasks of her employment as an Uber driver, relying on the respondent's psychological assessments.
The claims for medication expenses, interest, and a section 10 award were also dismissed.
Applicant's injuries fall within the MIG, but defective denial notices trigger insurer liability for certain treatment plans.
The respondent denied several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant's physical injuries were predominantly minor and that he failed to establish a pre-existing condition or psychological impairment warranting removal from the MIG.
However, the Tribunal found that the respondent failed to comply with the notice requirements under section 38(8) of the Schedule for several treatment plans.
As a result, the respondent was ordered to pay for physiotherapy services incurred during the period of non-compliance and for psychological services due to a defective denial notice that merely referenced a section 44 report without providing it to the applicant.
No co-appearing lawyers found.
No judges found.