2 total
Application for statutory accident benefits dismissed; applicant failed to prove treatment and assessment plans were reasonable and necessary.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to various treatment and assessment plans, including neuropsychological and neurological assessments, chiropractic services, massage therapy, acupuncture, and a functional ability assessment.
The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove on a balance of probabilities that the disputed plans were reasonable and necessary.
The Tribunal noted a lack of contemporaneous evidence from the applicant's treating family physician supporting the need for the requested interventions, and preferred the evidence of the respondent's section 44 assessor who found no objective evidence of residual musculoskeletal impairment.
Application for accident benefits dismissed due to uninsured vehicle exclusion and surveillance contradicting claimed impairments.
The applicant sought statutory accident benefits following an accident involving an all-terrain vehicle.
The insurer denied benefits, including income replacement benefits, attendant care benefits, and a determination of catastrophic impairment.
The Tribunal found the applicant was excluded from receiving income replacement benefits because he was operating an uninsured vehicle without a valid license.
The Tribunal also dismissed the claims for catastrophic impairment and other benefits, finding the applicant's self-reporting to medical assessors was unreliable and contradicted by video surveillance showing a higher level of functioning than reported.