Dr. S. M.-W. Tu

The applicant sought medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent insurer denied the treatment plans, which included a chronic pain assessment, attendant care assessment, chiropractic treatment, massage therapy, and assistive devices.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to demonstrate on a balance of probabilities that the proposed goods and services were reasonable and necessary.

The adjudicator noted a lack of contemporaneous medical evidence supporting ongoing functional impairment and relied on insurer's examination reports which concluded the applicant did not suffer from structural injuries or significant psychological impairment.

As no benefits were payable, the claim for interest was also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied funding for several treatment and assessment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The adjudicator found that the applicant failed to prove he suffered from a pre-existing condition, psychological injury, or chronic pain condition that would remove him from the MIG.

Relying on insurer's examinations and the lack of consistent medical complaints, the adjudicator concluded the injuries were predominantly minor.

The application for disputed benefits and interest was dismissed.