Dr. Robert Brian Hines

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, attendant care benefits, and numerous treatment plans for psychological, cognitive, and occupational therapy assessments and services.

The Tribunal found the claim for the non-earner benefit was statute-barred because the applicant failed to dispute the insurer's clear and unequivocal denial within the two-year limitation period.

The Tribunal dismissed the claims for the treatment plans and attendant care benefits, finding the applicant failed to prove they were reasonable and necessary for accident-related injuries, largely due to significant pre-existing psychological conditions and a lack of supporting medical evidence.

Claims for interest and an award for unreasonable delay were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to treatment plans for physiotherapy, psychological services, and chronic pain assessments outside the Minor Injury Guideline (MIG).

The respondent insurer denied the benefits, arguing the injuries were predominantly minor.

The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from chronic pain or a psychological impairment warranting removal from the MIG.

The Tribunal preferred the evidence of the respondent's section 44 assessors, noting the lack of objective medical evidence, the absence of complaints to family doctors, and Facebook posts showing the applicant performing physical activities without apparent discomfort.

The application was dismissed, and the applicant was limited to the remaining MIG funding.

The applicant sought accident benefits for psychological assessments and treatments following a motor vehicle accident, arguing her vehicular anxiety and psychological impairments fell outside the Minor Injury Guideline (MIG).

The arbitrator found that the applicant failed to meet her burden of proof.

Relying on the evidence of the applicant's family physician and the insurer's independent medical examiners, the arbitrator concluded the applicant's physical injuries had largely resolved and her vehicular anxiety did not constitute a psychiatric condition severe enough to remove her from the MIG.

As the $3,500 MIG cap had already been reached, the disputed treatment plans were not payable.

The insurer was awarded its expenses.