2 total
Applicant established entitlement to housekeeping benefits but payment denied because expenses were not proven incurred.
The applicant sought housekeeping and home maintenance (HH) benefits and a special award following a catastrophic motor vehicle accident.
The Tribunal found that the applicant's traumatic brain injury and physical impairments resulted in a substantial inability to perform his pre-accident HH tasks, rejecting the insurer's reliance on surveillance footage and an Examination Under Oath.
However, the Tribunal denied payment of the HH benefits because the applicant failed to prove the expenses were incurred under section 3(7)(e) of the Schedule.
The claim for a section 10 award was dismissed as the insurer's conduct was not excessive or imprudent.
Application for accident benefits dismissed; bicycle crash into construction sign did not involve an automobile.
The applicant sought statutory accident benefits after crashing his bicycle into a construction sign.
He alleged that an unidentified truck sped up behind him, forcing him to swerve and hit the sign.
The respondent denied benefits on the basis that the incident did not involve an automobile.
The Tribunal found the applicant's evidence inconsistent and unreliable, noting that hospital records and the initial police report did not mention an automobile.
The Tribunal concluded the incident did not meet the purpose test for an 'accident' under s. 3(1) of the Schedule and dismissed the application.
