2 total
Application for income replacement and medical benefits dismissed for lack of objective medical evidence.
The applicant sought an income replacement benefit and medical benefits for physiotherapy and a psychological assessment following a motor vehicle accident.
The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove a substantial inability to perform the essential tasks of her employment.
The Tribunal also found the proposed medical benefits were not reasonable and necessary, noting a lack of objective medical evidence and contradictory expert reports.
Income replacement benefits denied due to non-compliance with information requests and failure to prove disability.
The applicant was injured in a motor vehicle accident and sought Income Replacement Benefits (IRBs).
The insurer suspended and later terminated the benefits, arguing the applicant failed to provide requested financial documentation under s. 33 of the Schedule and no longer met the disability test.
The Tribunal found that the applicant breached s. 33 without a reasonable explanation, disentitling her to benefits for the period of non-compliance.
Furthermore, the Tribunal held that the applicant failed to prove on a balance of probabilities that she suffered a substantial inability to perform the essential tasks of her employment as a restaurant owner, relying on the insurer's multidisciplinary assessments.
The application and request for costs were dismissed.
No co-appearing lawyers found.
No judges found.