William Brennan

The applicant sought a medical benefit of $1,482.00 for a physiotherapy treatment plan following a motor vehicle accident.

The respondent denied the plan based on an insurer examination which concluded the treatment was not reasonable and necessary.

The adjudicator found that the applicant's back and neck injuries were pre-existing and not accident-related.

Furthermore, the proposed treatment was substantially similar to previous physiotherapy that had worsened the applicant's condition.

The application was dismissed and no interest was payable.

The applicant sought statutory accident benefits five and a half years after a motor vehicle accident.

The insurer denied the claims and argued the application was time-barred.

The Tribunal held the applicant was not barred from proceeding because the insurer failed to advise her that she could be permanently disentitled if she did not provide a reasonable explanation for the delay.

The Tribunal also found the insurer failed to provide notice within 10 days that it was relying on the Minor Injury Guideline (MIG), meaning it could not rely on the MIG limit and had to pay for physiotherapy incurred during the default period.

However, the Tribunal dismissed the claims for psychological services and prescription medication, finding the applicant failed to prove they were reasonable and necessary or temporally connected to the accident.

The applicant sought accident benefits following a motor vehicle accident but failed to attend a pre-hearing discussion and the subsequent arbitration hearing.

The applicant's counsel sought to be removed from the record but was denied for failing to comply with Rule 9.7 of the Dispute Resolution Practice Code.

As the applicant failed to appear and presented no evidence to support her claims, the application for arbitration was dismissed without costs.