2 total
Accident benefits denied as applicant failed to prove injuries fell outside the Minor Injury Guideline.
The applicant sought payment for a general practitioner's assessment and psychological services following a motor vehicle accident.
The insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant failed to prove she suffered from a psychological impairment or chronic pain syndrome that would remove her from the MIG.
The Tribunal preferred the insurer's expert evidence, which included psychometric testing, over the applicant's evidence.
The claims for the assessment, psychological services, and interest were dismissed.
Arbitrator approves all six disputed treatment plans for chronic pain and depression but denies special award.
The Applicant was injured in a motor vehicle accident and sought statutory accident benefits for various treatment plans, including rehabilitation, occupational therapy, rehabilitation support worker, and psychological services.
The Insurer denied the plans based on assessments from its own experts.
The Arbitrator found the Applicant's experts, who diagnosed chronic pain syndrome and severe depression, to be more credible and qualified than the Insurer's assessors.
All six treatment plans were deemed reasonable and necessary and were approved.
However, the Arbitrator declined to order a special award, finding that the Insurer had not acted unreasonably in requesting assessments and denying the claims given the circumstances.
No co-appearing lawyers found.
No judges found.