2 total
Arbitrator denied caregiver and medical benefits but awarded partial housekeeping benefits following a motor vehicle accident.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the insurer, including caregiver, housekeeping, and medical benefits.
The insurer terminated caregiver and housekeeping benefits after an occupational therapy in-home assessment.
The arbitrator found that the applicant was not substantially unable to perform her pre-accident caregiving activities, as she could still perform the essential tasks, and denied caregiver benefits.
The claim for medical benefits was denied for lack of evidence.
However, the arbitrator found the applicant was substantially unable to perform some of her pre-accident housekeeping tasks due to pain, and awarded housekeeping benefits at a reduced rate of $50 per week.
Each party was ordered to bear their own arbitration expenses.
Insurer ordered to pay ongoing accident benefits and a special award despite an intervening second accident.
The applicant was injured in a 1996 motor vehicle accident and received statutory accident benefits until the insurer terminated them.
The applicant was subsequently involved in a second accident in 1997.
The insurer argued the ongoing impairments and need for treatment were caused by the second accident.
The arbitrator found that the 1996 accident materially contributed to the applicant's ongoing physical and psychological impairments, including a herniated disc.
The arbitrator ordered the insurer to pay ongoing income replacement benefits, chiropractic and psychological treatment expenses, and a 25% special award for unreasonably withholding payment for psychological treatment.
The claim for housekeeping expenses was dismissed.
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