2 total
Applicant not barred from hearing; insurer's request for duplicative physical examinations was unreasonable.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent insurer raised a preliminary issue, arguing the applicant was barred from proceeding to a hearing for an income replacement benefit because he failed to attend three insurer's examinations.
The Tribunal found that the requested examinations were duplicative and unreasonable, as the applicant had attended examinations with the exact same assessors just two months prior, and there was no rational connection between a suspected change in employment status and a new round of physical examinations.
The Tribunal held that the requests did not comply with s. 44 of the Schedule, and therefore the s. 55 procedural bar did not apply.
Application for accident benefits dismissed as the applicant's injuries fell within the Minor Injury Guideline.
The applicant sought statutory accident benefits for physiotherapy services following a motor vehicle accident.
The respondent insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The adjudicator found that the applicant failed to prove on a balance of probabilities that his injuries warranted removal from the MIG due to a pre-existing condition, chronic pain, or psychological impairment.
As the $3,500 MIG limit had already been exhausted, the treatment plans were not payable.
The application was dismissed.
