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Appeal dismissed and cross-appeal allowed; insured ordered to repay interim benefits and excessive psychological treatment fees.
The appellant was injured in a 1993 motor vehicle accident and claimed ongoing weekly income benefits and psychological treatment expenses.
The insurer terminated benefits in 1997.
The arbitrator found the appellant was not entitled to weekly benefits beyond July 1997 and ordered her to repay a portion of the psychological treatment fees, finding the frequency of sessions unreasonable.
On appeal, the Director's Delegate upheld the arbitrator's findings, noting the appellant's significant pre-existing psychological issues and lack of objective evidence of ongoing disability.
The insurer's cross-appeal was allowed, and the appellant was ordered to repay $17,371.20 in interim benefits previously awarded.
Income replacement benefits awarded for a closed period due to psychological impairment; other claims dismissed.
The applicant was injured in a motor vehicle accident and received income replacement benefits for 104 weeks.
The insurer terminated benefits, and the applicant sought ongoing income replacement, attendant care, and housekeeping benefits.
The arbitrator found that the applicant did not suffer a complete inability to engage in suitable employment due to physical injuries, but did suffer such an inability due to psychological complications (severe depression and anxiety) until her condition stabilized.
The arbitrator awarded income replacement benefits for a closed period.
The claims for attendant care and housekeeping expenses were dismissed because the applicant failed to prove she incurred a cost or obligation to pay her husband for those services.
Interim weekly income benefits granted; production of treating psychologist's clinical notes denied to prevent harm.
The applicant was injured in a motor vehicle accident and received statutory accident benefits until the insurer terminated them.
The applicant brought a motion for interim weekly income benefits, and the insurer brought a cross-motion for the production of the clinical notes of the applicant's treating psychologist.
The arbitrator granted the motion for interim benefits, finding the applicant had established a prima facie case for entitlement and demonstrated financial need.
The arbitrator dismissed the insurer's motion for production of the clinical notes, finding the potential harm to the applicant's treatment outweighed the probative value of the notes, but ordered the production of raw testing data to the insurer's psychologist.
No co-appearing lawyers found.
No judges found.