2 total
Psychological assessment granted due to pre-accident history; physical treatment and assessments denied for lacking medical evidence.
The applicant sought entitlement to statutory accident benefits following a motor vehicle accident, including treatment plans for physiotherapy, an attendant care assessment, a psychological assessment, and an orthopaedic surgery assessment.
The respondent denied the benefits, initially relying on the Minor Injury Guideline before removing the applicant due to pre-existing psychological issues.
The Tribunal found the applicant failed to prove the physiotherapy, attendant care assessment, and orthopaedic assessment were reasonable and necessary, citing a lack of supporting medical evidence and normal imaging.
However, the Tribunal granted the psychological assessment, finding sufficient evidence of a pre-existing psychological condition that flared up post-accident to warrant further investigation.
Application for accident benefits dismissed; injuries fell within Minor Injury Guideline and non-earner benefit denied.
The applicant was involved in a motor vehicle accident and sought statutory accident benefits, which were denied by the respondent insurer.
The applicant applied to the Licence Appeal Tribunal to dispute the denial of a non-earner benefit, various treatment plans, and the determination that his injuries fell within the Minor Injury Guideline (MIG).
The adjudicator found that the applicant's injuries were predominantly minor, as there was no compelling evidence of a pre-existing condition or that the injuries fell outside the MIG.
The adjudicator also dismissed the claim for a non-earner benefit, noting the applicant returned to work as an Uber driver shortly after the accident and failed to demonstrate a complete inability to carry on a normal life.
Consequently, the disputed treatment plans were denied as they exceeded the exhausted MIG limits, and no interest was awarded.
