Applicant's injuries deemed minor and subject to MIG funding limit; chronic pain claim rejected.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent insurer determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and refused to pay for certain physiotherapy treatment plans.
The applicant applied to the Licence Appeal Tribunal, arguing that chronic pain removed them from the MIG.
The adjudicator found that the applicant's pain was intermittent and did not meet the criteria for chronic pain syndrome, preferring the evidence of the respondent's independent medical examiner over the applicant's family physician.
The adjudicator concluded the injuries were predominantly minor and subject to the $3,500 funding limit.
One treatment plan was denied as it proposed treatment outside the MIG, while another was approved subject to the funding limit.
No interest was awarded.
OLATOntario Licence Appeal TribunalSep 25, 2019
