2 total
Tribunal denies physiotherapy plan but partially approves psychological treatment plans for accident benefits.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy and psychological services.
The respondent denied the treatment plans, and the applicant applied to the Licence Appeal Tribunal.
The Tribunal found that the applicant failed to prove the physiotherapy plan was reasonable and necessary, as the medical evidence did not corroborate the need for the proposed treatments and the applicant had reported physiotherapy made her worse.
However, the Tribunal partially approved the psychological treatment plans, finding the requested time for mental health testing and completing the OCF-18 form to be reasonable, while reducing the time claimed for session preparation and notetaking.
The applicant was awarded $274.81 for psychological services plus interest.
Insurer ordered to pay for treatment plans and special awards due to procedural non-compliance.
The applicants were injured in a motor vehicle accident and sought payment for chiropractic treatment and housekeeping expenses from their insurer.
The arbitrator found the applicants' evidence regarding the necessity of the treatment and housekeeping services to be implausible and unreliable.
However, because the insurer failed to comply with the mandatory procedures under section 38(12) of the Schedule for rejecting a treatment plan, the arbitrator ordered the insurer to pay for the second treatment plans submitted by the applicants.
The arbitrator also awarded each applicant a $500 special award due to the insurer's procedural non-compliance, but denied the claims for housekeeping expenses and ordered each party to bear their own arbitration expenses.
No co-appearing lawyers found.
No judges found.