3 total
Accident benefits claim dismissed; applicant failed to prove chronic pain or psychological impairments warranted MIG removal.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued she should be removed from the MIG due to chronic pain with functional impairment and psychological impairments.
The Tribunal found the applicant did not meet her burden to prove her injuries fell outside the MIG, noting inconsistencies in her expert reports and a lack of documented functional impairment in her primary care records.
As the MIG applied, the disputed treatment plans were not payable.
Claims for interest, a special award, and costs were also dismissed.
Treatment plans for chiropractic services approved; insurer's request to exclude medical records denied.
The applicant was injured in a motor vehicle accident and sought payment for three treatment plans for chiropractic services, which the respondent insurer denied.
The respondent also sought to exclude the clinical notes and records of the applicant's family physician due to alleged late disclosure, which the Tribunal denied as the respondent had prior notice of them.
The Tribunal found the treatment plans reasonable and necessary, preferring the evidence of the applicant's assessors and treating physician over the respondent's insurer examinations.
The applicant was awarded the cost of the treatment plans and interest on overdue payments.
Applicant awarded medical, attendant care, and housekeeping benefits due to insurer's procedural breaches; non-earner benefits denied.
The applicant was injured in a motor vehicle accident and sought various statutory accident benefits, including non-earner, medical, attendant care, and housekeeping benefits.
The insurer suspended benefits after the applicant failed to attend an examination under oath, though a previous arbitrator found the notices defective.
The arbitrator found the applicant entitled to the disputed medical treatment plans, as well as attendant care and housekeeping benefits for a limited period due to the insurer's procedural breach in failing to provide assessment reports in a timely manner.
However, the claim for non-earner benefits was dismissed as the applicant did not meet the test of a complete inability to lead a normal life.
The request for a special award was also denied.
No co-appearing lawyers found.
No judges found.