Ms. Mohan

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the respondent insurer.

The applicant claimed entitlement to attendant care benefits and several treatment plans, including occupational therapy, physiotherapy, spinal decompression therapy, and various assessments.

The Tribunal found that the applicant did not meet the burden of proving entitlement to attendant care benefits, as the medical evidence indicated functional range of motion and independence in self-care tasks.

The Tribunal also denied the claims for occupational therapy, physiotherapy, and the neurological and chronic pain assessments, either because the applicant failed to provide sufficient submissions or because the insurer's denials were compliant with the Schedule.

However, the Tribunal granted the claim for spinal decompression therapy, finding it reasonable and necessary based on a physician's recommendation supported by objective diagnostic imaging.

The applicant was also awarded interest on the overdue payment.

The applicant sought statutory accident benefits for a $1,000 orthopaedic mattress following a motor vehicle accident.

The respondent denied the benefit, relying on an insurer's examination report which concluded the mattress was unlikely to assist in managing pain.

The Tribunal found the mattress to be reasonable and necessary, noting that multiple treating practitioners and assessors documented the applicant's ongoing sleep disturbances and fatigue.

The Tribunal afforded less weight to the respondent's expert, whose opinion was inconsistent with other medical evidence.

The applicant was awarded the cost of the mattress plus interest.