2 total
Application for accident benefits dismissed as applicant failed to prove treatments were reasonable and necessary.
The applicant sought statutory accident benefits for physiotherapy and chiropractic treatments following a motor vehicle accident.
The insurer denied the treatment plans.
The Tribunal found that the applicant failed to prove the treatments were reasonable and necessary, noting a lack of contemporaneous medical evidence and the fact that the applicant had already received concurrent physical therapies.
The Tribunal also found the insurer's denial notices complied with s. 38(8) of the Schedule.
The application was dismissed.
Attendant care assessment approved but chiropractic and physiotherapy treatment plans denied for lack of evidence.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for chiropractic services, physiotherapy services, and an attendant care assessment.
The respondent denied the benefits.
The Tribunal found that the applicant failed to prove the chiropractic and physiotherapy treatment plans were reasonable and necessary due to a lack of contemporaneous medical evidence.
However, the Tribunal approved the attendant care assessment, noting that the respondent's own subsequent request for a functional abilities evaluation contradicted its position that an assessment was not warranted.
The applicant was also awarded interest on the overdue payment for the assessment.
