Dr. Temple

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for psychological assessments, psychological treatment, and physiotherapy.

The respondent insurer denied the benefits.

The Licence Appeal Tribunal found that the applicant failed to discharge the burden of proving that the proposed treatments and assessments were reasonable and necessary.

The Tribunal preferred the evidence of the respondent's experts, who found minimal psycho-emotional distress and no objective evidence of physical impairment, over the conflicting and inconsistent reports of the applicant's experts.

The application was dismissed.

The applicant was injured in a motor vehicle accident and received weekly income benefits from the insurer until they were terminated.

The applicant sought ongoing benefits, claiming physical and psychological disability.

The arbitrator found that the applicant's physical injuries had resolved and that there was no organic basis for his ongoing complaints.

Medical and vocational assessments indicated symptom magnification, malingering, and an unreasonable refusal to attempt a return to work.

The arbitrator concluded the applicant was not disabled beyond the termination date.

However, the arbitrator found the insurer had miscalculated the benefit amount prior to termination by improperly deducting ceasing business expenses, resulting in an underpayment.

The insurer was ordered to pay the arrears with interest, and the applicant was awarded one third of his hearing expenses.