Mr. Grimaldi

The applicant requested a reconsideration of a decision denying an award for the respondent's alleged unreasonable withholding of income replacement benefits and costs.

The applicant argued the Tribunal erred in relying on the respondent's expert testimony and failing to consider the applicant's overall condition.

The Tribunal found no material error of law or fact that would have changed the outcome, noting that the respondent appropriately adjusted the claim and reasonably relied on its medical assessors.

The request for reconsideration was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit (IRB), physiotherapy, catastrophic impairment assessments, and a special award.

The Tribunal found the applicant was substantially unable to perform his pre-accident employment due to chronic pain, entitling him to an IRB up to the 104-week mark.

However, the applicant failed to prove a complete inability to engage in any suitable employment, denying him post-104 week IRBs.

The disputed treatment plans for physiotherapy and catastrophic impairment assessments were deemed not reasonable and necessary.

The claim for a special award was dismissed as the insurer reasonably relied on its medical assessments.