4 total
Application for statutory accident benefits dismissed as applicant failed to prove complete inability to carry on normal life.
The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, chiropractic treatment plans, and a psychological assessment.
The respondent denied the benefits based on section 44 insurer examinations.
The Tribunal found that the applicant failed to prove a complete inability to carry on a normal life, as medical evidence showed she could perform personal care, grocery shop, and swim.
The Tribunal also dismissed the claims for medical benefits, preferring the respondent's expert evidence that the treatments were not reasonable and necessary.
The application was dismissed in its entirety.
Application for accident benefits dismissed; applicant failed to establish chronic pain warranting removal from MIG.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued she should be removed from the MIG due to chronic pain.
The Tribunal found that the applicant failed to establish on a balance of probabilities that she suffered accident-related chronic pain with a functional impairment.
As the applicant remained within the MIG and the limits were exhausted, the disputed treatment plans were not payable.
The application was dismissed.
Application for accident benefits dismissed; injuries found to be within the Minor Injury Guideline.
The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant failed to prove his injuries warranted removal from the MIG, as he did not establish chronic pain with functional impairment, a pre-existing condition preventing maximal recovery, or an accident-related psychological impairment.
The Tribunal also dismissed the claim for a non-earner benefit, finding the applicant did not suffer a complete inability to carry on a normal life.
Claims for treatment plans, interest, and an award for unreasonable delay were consequently dismissed.
Application for statutory accident benefits granted in part; reduced physiotherapy approved but assessments denied.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy, an attendant care assessment, and a chronic pain assessment.
The respondent insurer denied the benefits.
The Tribunal found the applicant was entitled to a reduced amount for physiotherapy, as the clinical records supported the need for treatment to reduce pain and improve functionality.
However, the Tribunal denied the requests for the attendant care and chronic pain assessments, finding insufficient medical evidence to demonstrate they were reasonable and necessary.
The application was granted in part.
