Shalini M. Thomas

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that his injuries fell within the Minor Injury Guideline (MIG).

The applicant also claimed entitlement to an income replacement benefit (IRB) and two treatment plans.

The Licence Appeal Tribunal found that the applicant's physical injuries were minor and that he failed to establish a pre-existing psychological condition that would preclude recovery within the MIG.

The Tribunal also dismissed the IRB claim, noting the applicant failed to provide evidence of his pre-accident employment tasks and was found functionally capable of working by the insurer's assessors.

The claims for treatment plans and interest were similarly dismissed.

The applicant sought medical and rehabilitation benefits following a motor vehicle accident.

The respondent insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The adjudicator found that the applicant failed to meet the burden of proving his physical, psychological, or chronic pain impairments removed him from the MIG.

The adjudicator preferred the respondent's psychological assessment over the applicant's due to the use of an interpreter, and relied on surveillance evidence that contradicted the applicant's claims of chronic pain.

The application was dismissed.

The applicant insurer sought repayment of $21,600 in income replacement benefits (IRBs) paid to the respondent, alleging she wilfully misrepresented her employment status at the time of the accident.

The insurer also sought $571.78 in cancellation fees for the respondent's failure to attend Examinations Under Oath.

The respondent, who was self-represented, did not attend the written hearing.

The Tribunal found that the insurer failed to prove on a balance of probabilities that the respondent made a wilful misrepresentation, noting that the evidence relied upon predated the accident or was otherwise insufficient.

The Tribunal also dismissed the claim for cancellation fees as the insurer provided no authority or evidence to support it.

The insurer's application was dismissed.