22 total
Accident benefits denied as injuries fell within Minor Injury Guideline and applicant's expert evidence was tainted by conflict of interest.
The Applicant sought statutory accident benefits following a motor vehicle accident.
The Insurer denied several treatment plans and assessments, arguing the Applicant's injuries fell within the Minor Injury Guideline (MIG).
The arbitrator found that the Applicant's psychological and orthopaedic expert reports were tainted by a conflict of interest, as the primary psychologist had a close personal and financial relationship with the Applicant, and other experts relied on her clinic's flawed assessments.
The arbitrator excluded or gave no weight to the Applicant's expert evidence and accepted the Insurer's independent medical examinations.
The arbitrator concluded the injuries were predominantly minor and dismissed the claims for further benefits.
Claim for Special Award dismissed as insurer acted reasonably in relying on medical assessments.
The applicant was injured in a motor vehicle accident and sought accident benefits.
The parties settled the claims for income replacement and medical benefits, leaving only the issue of whether the applicant was entitled to a Special Award under s. 282(10) of the Insurance Act for the insurer's initial denial of benefits.
The arbitrator found that the insurer acted reasonably at all relevant times based on the medical information available, which supported a theory that the applicant's impairments were due to pre-existing degenerative disc disease rather than the accident.
The claim for a Special Award was dismissed.
No co-appearing lawyers found.
No judges found.