The applicants, a mother and daughter, were injured in a motor vehicle accident and sought statutory accident benefits from their insurer.
The insurer denied further medical treatment, housekeeping benefits, and the cost of in-home assessments.
The arbitrator found that the insurer's procedural breaches in denying the treatment plans did not automatically entitle the applicants to the benefits.
The arbitrator denied the majority of the claimed medical benefits, preferring the opinions of the Designated Assessment Centres that further facility-based passive treatment was not reasonable and necessary.
The daughter was awarded a small amount for a home exercise program and an unpaid balance of an uncontradicted treatment plan.
The mother was awarded housekeeping benefits at a reduced rate for a limited period, but the daughter's housekeeping claim was denied due to lack of evidence that she performed such duties pre-accident.
The claims for in-home assessments were denied as they were conducted at a residence where the applicants did not live at the time.
