3 total
Application for statutory accident benefits dismissed as treatments were not proven reasonable and necessary.
The applicant sought statutory accident benefits following a motor vehicle accident, including a chronic pain assessment, chiropractic treatment, and psychological services.
The Licence Appeal Tribunal found that the chronic pain assessment was incurred before the treatment plan was submitted, barring the claim.
The Tribunal also found that the applicant failed to prove the chiropractic and psychological treatments were reasonable and necessary, preferring the respondent's independent medical examination evidence.
The respondent's request for costs due to the applicant's failure to produce extended health care documents was denied, as no pecuniary prejudice was demonstrated.
The application was dismissed.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent insurer denied the claims, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.
The applicant argued her pre-existing knee osteoarthritis, psychological impairments, and chronic pain removed her from the MIG.
The Tribunal found the pre-existing condition was not exacerbated by the accident and did not prevent maximal recovery.
The Tribunal also found insufficient medical evidence to support a psychological impairment or chronic pain diagnosis that would remove the applicant from the MIG.
The applicant sought statutory accident benefits following a motor vehicle accident, specifically a medical benefit of $4,652.42 for physiotherapy.
The respondent denied the claim on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and were subject to the $3,500 limit.
The Licence Appeal Tribunal found that the applicant's physical injuries were predominantly minor strains and sprains.
The Tribunal also found no compelling evidence of a pre-existing condition that would remove the applicant from the MIG.
Consequently, the claim for the physiotherapy treatment plan was dismissed, and no interest was payable.
No co-appearing lawyers found.
No judges found.