2 total
Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied the claims, asserting the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued for removal from the MIG based on physical injuries, psychological impairments, and chronic pain.
The Tribunal found the applicant failed to establish that her injuries warranted removal from the MIG, noting a lack of evidence connecting a shoulder tear to the accident, subclinical psychological test results, and failure to meet the AMA Guides criteria for chronic pain.
Consequently, the disputed treatment plans were deemed not reasonable and necessary, and the claims for an award and interest were dismissed.
Plaintiff failed to meet Insurance Act threshold for permanent serious impairment.
During a jury trial arising from a motor vehicle accident, the defendants brought a threshold motion under s. 267.5 of the Insurance Act to determine whether the plaintiff had sustained a permanent serious impairment of an important physical, mental, or psychological function.
The court assessed extensive medical evidence concerning shoulder injuries, surgeries, and alleged chronic pain.
While the court accepted that the accident aggravated a pre-existing shoulder condition requiring surgical treatment, it found the plaintiff’s evidence of ongoing limitations unreliable and inconsistent with medical opinions and surveillance evidence.
The court concluded that the plaintiff had not established, on a balance of probabilities, that any impairment was permanent, serious, or sufficiently impactful on important functions.
The statutory threshold was therefore not met and the claim for non‑pecuniary damages was barred.
