24 total
Accident benefits claims dismissed as applicant lacked credibility and failed to prove catastrophic impairment.
The applicant sought accident benefits following a motor vehicle accident, claiming her injuries were catastrophic.
The arbitrator found the applicant lacked credibility, noting she had returned to work shortly after the accident, retrained for a more physically demanding job, and was observed on surveillance performing activities she claimed she could not do.
The arbitrator preferred the insurer's expert evidence over the applicant's, concluding the applicant failed to prove her injuries were catastrophic or that the claimed attendant care and medical benefits were reasonable, necessary, and directly caused by the accident.
All claims were dismissed.
Catastrophic impairment claim dismissed as applicant's combined impairments fell short of the 55% threshold.
The applicant was injured in a motorcycle accident and sought a determination that he sustained a catastrophic impairment, along with claims for attendant care benefits and a special award.
The arbitrator evaluated competing medical assessments and preferred the insurer's experts, finding the applicant's combined physical and psychological impairments amounted to 49% Whole Person Impairment, falling short of the 55% threshold.
The claim for attendant care benefits was dismissed as the applicant failed to demonstrate an economic loss incurred by his wife and medical assessments indicated he was independent in self-care.
The request for a special award was denied because the insurer had not unreasonably withheld benefits.
The applicant was ordered to pay the insurer's hearing expenses.
Application for catastrophic impairment designation dismissed as whole person impairment was assessed at 28%.
The applicant sought a determination that she was catastrophically impaired following a motor vehicle accident, claiming marked or extreme impairment due to a mental or behavioural disorder, or alternatively, a 55% or more whole person impairment (WPI).
The arbitrator found that the applicant did not suffer a marked or extreme mental or behavioural impairment.
After evaluating conflicting medical evidence regarding her physical and cognitive injuries, the arbitrator assessed her combined WPI at 28%, well below the 55% threshold.
The applicant was awarded $6,000 for the costs of catastrophic assessments, but her claims for attendant care benefits were dismissed.
The insurer was awarded its arbitration expenses.
Applicant found catastrophically impaired based on wheelchair dependency and combined physical and psychological impairments.
The applicant was injured in a motor vehicle accident and applied for a catastrophic impairment designation under the Statutory Accident Benefits Schedule.
The insurer argued the applicant required a below-knee amputation and assessed her as an amputee, resulting in a 35% Whole Person Impairment (WPI) rating.
The applicant's assessors found her to be wheelchair dependent, resulting in an 80% WPI rating under the Gait Derangement Table, and also found significant psychological impairments.
The Arbitrator preferred the applicant's assessors, finding that the insurer's assessors failed to evaluate the applicant as she presented herself.
The Arbitrator concluded the applicant was wheelchair dependent and met the definition of catastrophic impairment.
No co-appearing lawyers found.
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