Applicant's injuries deemed minor and subject to MIG limit due to insufficient medical evidence.
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 its $3,500 funding limit.
The applicant argued that pre-existing shoulder and psychological issues, along with accident-related chronic pain and psychological impairment, removed him from the MIG.
The Tribunal found insufficient medical evidence to support the applicant's claims, noting inconsistencies between the applicant's self-reports, his family physician's records, and the insurer's examinations.
The Tribunal concluded the injuries were predominantly minor and subject to the MIG limit, which the respondent had already substantially paid.
The disputed treatment plans were therefore not payable.
OLATOntario Licence Appeal TribunalAug 19, 2021
