2 total
Application for accident benefits dismissed; injuries fell within the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied medical benefits beyond the $3,500 Minor Injury Guideline limit.
The applicant argued for removal from the guideline based on psychological impairment and chronic pain.
The Tribunal found the applicant's injuries were predominantly minor soft tissue injuries and their clinically associated sequelae.
The Tribunal preferred the evidence of the applicant's family physician and the respondent's psychological assessor over the applicant's expert reports, which were either based solely on self-reporting or outside the assessor's scope of practice.
The application was dismissed.
Application for accident benefits dismissed as proposed chiropractic and psychological treatments were not reasonable and necessary.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for chiropractic and psychological services.
The respondent insurer denied the treatment plans based on insurer examinations which found no objective physical impairments and concluded that the applicant's psychological symptoms were related to pre-existing behavioural issues rather than the accident.
The adjudicator agreed with the respondent's medical experts, finding that the applicant failed to prove the treatments were reasonable and necessary.
No co-appearing lawyers found.
No judges found.