4 total
Application for accident benefits dismissed as applicant failed to provide medical evidence overcoming the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued that the respondent's denials were invalid because the insurer's examination (IE) report was procured with improper notice.
The Tribunal found that the applicant's participation in the IE rendered the notice issue moot and refused to strike the report.
As the applicant provided no medical evidence or submissions on the merits of his claim, he failed to meet his onus to demonstrate that his injuries fell outside the MIG or that the disputed treatment plans were reasonable and necessary.
The application was dismissed.
Applicant's psychological injuries removed her from the Minor Injury Guideline; disputed treatment plans approved.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits.
The insurer denied several treatment and assessment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found that the applicant sustained psychological injuries that removed her from the MIG.
The Tribunal ordered the insurer to pay for the disputed psychological, physiotherapy, and chronic pain assessments and treatments, finding them reasonable and necessary.
The applicant's claim for an award under Regulation 664 was dismissed because the insurer reasonably relied on its assessors' reports.
Physiotherapy treatment plan denied as not reasonable and necessary due to lack of improvement and treatment gaps.
The applicant was injured in a motor vehicle accident and sought funding for a physiotherapy treatment plan in the amount of $3,078.72.
The respondent denied the treatment plan.
The Licence Appeal Tribunal found that the treatment plan was not reasonable and necessary, noting significant gaps in the applicant's treatment history and a lack of improvement despite previous facility-based treatment.
The Tribunal accepted the respondent's medical examination evidence that the applicant had reached maximum medical improvement and could manage her symptoms with a home-based exercise program.
The claims for an award and interest were also dismissed.
Application for accident benefits beyond the Minor Injury Guideline dismissed due to insufficient medical evidence.
The respondent insurer determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and refused to fund treatment plans exceeding the $3,500 limit.
The applicant applied to the Licence Appeal Tribunal, arguing that pre-existing conditions, psychological injuries, and chronic pain warranted removal from the MIG.
The Tribunal found that the applicant failed to provide sufficient medical evidence to support removal from the MIG, noting that the psychological report's conclusions were unsupported by its own psychometric testing and uncorroborated by other medical records.
The application was dismissed, and the disputed treatment plans were denied as the MIG funding limit had been exhausted.
No co-appearing lawyers found.
No judges found.