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Tribunal awards attendant care and medical assessments to catastrophically impaired applicant but denies other treatment plans.
The applicant was injured in a motor vehicle accident and sought various statutory accident benefits after being deemed catastrophically impaired.
The Licence Appeal Tribunal found that the applicant was entitled to assessments proposed by Omega Medical Assessments and attendant care benefits of $2,126.07 per month, as the medical evidence supported their reasonableness and necessity.
However, claims for rehabilitation services, a speech-language pathology assessment, fitness classes, and housekeeping benefits were dismissed due to insufficient evidence or surveillance contradicting the applicant's claims.
Interest was awarded on the payable benefits.
Insurer ordered to pay occupational services treatment plan due to non-compliant denial notice; other benefits denied.
The applicant sought entitlement to various statutory accident benefits following a motor vehicle accident, including multiple treatment plans and attendant care benefits.
The Tribunal found that the applicant failed to meet her onus to prove that the majority of the treatment plans and the attendant care benefits were reasonable and necessary.
However, the Tribunal ordered the respondent to pay $2,013.20 for occupational services because the respondent's denial notice failed to provide sufficient medical reasons as required by section 38(8) of the Schedule.
Claims for a section 10 award and the cost of an OCF-3 were dismissed.
No co-appearing lawyers found.
No judges found.