Leanne C. Storms

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent insurer determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied further treatment plans, non-earner benefits, and attendant care benefits.

The Licence Appeal Tribunal found that the applicant failed to prove he sustained psychological injuries that would remove him from the MIG.

As the applicant had exhausted the $3,500 MIG limit, the disputed treatment plans were not payable.

The Tribunal also dismissed the claims for non-earner and attendant care benefits, finding insufficient evidence of a complete inability to carry on a normal life.

The application was dismissed.

The applicant, who was confined to a wheelchair following a motor vehicle accident, sought interim attendant care, caregiving, and housekeeping benefits after the insurer terminated them at the 104-week mark.

The insurer relied on a surveillance video and medical assessments suggesting the applicant was malingering.

The arbitrator found the surveillance video to be of questionable probative value and tainted the insurer's medical evidence.

Applying the prima facie and urgency/necessity tests, the arbitrator granted the interim benefits, noting the extraordinary hardship on the applicant's family who were providing his care.