3 total
Application for accident benefits dismissed; injuries fell within Minor Injury Guideline and denial notices were compliant.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied medical benefits beyond the $3,500 Minor Injury Guideline limit.
The applicant argued his injuries, including chronic pain, exceeded the minor injury definition and that pre-existing conditions warranted removal from the guideline.
The Tribunal found the applicant's injuries were predominantly minor soft tissue injuries and rejected the evidence of his chiropractor regarding chronic pain.
The Tribunal also found the respondent's denial notices complied with the statutory timelines.
The application was dismissed.
Application for accident benefits dismissed; injuries fell within Minor Injury Guideline and IRB test not met.
The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that her injuries fell within the Minor Injury Guideline (MIG) and claiming entitlement to income replacement benefits (IRBs) and various medical benefits.
The adjudicator found that the insurer complied with the notice requirements under s. 38(8) of the Schedule.
Relying on insurer examinations and surveillance evidence that contradicted the applicant's self-reports of impairment, the adjudicator concluded the applicant sustained predominantly minor injuries and did not suffer from chronic pain caused by the accident.
As the $3,500 MIG limit was exhausted, the medical benefits were denied.
The claim for IRBs was also dismissed because the applicant failed to establish a substantial inability to perform the essential tasks of her employment, having returned to work for five weeks immediately after the accident.
Accident benefits claims dismissed entirely due to devastating surveillance evidence and unreliable, altered expert medical reports.
Three family members sought statutory accident benefits following a minor motor vehicle collision.
The arbitrator dismissed all claims for income replacement, caregiver, attendant care, housekeeping, and medical/rehabilitation benefits.
The arbitrator found the applicants were not credible, relying heavily on surveillance evidence that contradicted their reported disabilities.
Furthermore, the applicants' expert medical evidence was rejected due to altered clinical records, failure of experts to testify, and reliance on inaccurate self-reporting.
Claims for interest, a special award, and arbitration expenses were also dismissed.
No co-appearing lawyers found.
No judges found.