Dr. Margaret White

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs) and occupational therapy treatment plans for a concussion.

The respondent insurer denied the benefits, maintaining that the applicant's injuries fell within the Minor Injury Guideline (MIG) and relying on insurer's examinations.

The Tribunal found the applicant was entitled to IRBs for a limited period before they were validly suspended for non-compliance with a section 33 request.

The Tribunal also approved the occupational therapy plans in part, finding the respondent's reliance on assessors who ignored the concussion diagnosis to be unreasonable.

The Tribunal awarded a maximum 50% special award under section 10 of Regulation 664, condemning the respondent's excessive and inflexible conduct in keeping the applicant in the MIG despite clear medical evidence of a concussion.

The applicant, a taxi driver, was injured in a rear-end motor vehicle accident and sought statutory accident benefits.

The insurer terminated his income replacement benefits (IRBs) and denied certain medical and assessment treatment plans.

The arbitrator found that the applicant suffered from chronic pain syndrome and psychological impairments, entitling him to both pre-104-week and post-104-week IRBs.

The disputed medical and assessment plans were denied for lack of evidence of reasonableness and necessity at the time of submission.

The arbitrator awarded a maximum 50% special award against the insurer, finding it unreasonably withheld benefits by ignoring mounting medical evidence of the applicant's psychological and cognitive impairments and relying solely on outdated physical assessments.