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A.V. v. Certas Home and Auto Insurance Company (18-007875)

  • March 2, 2020

The claimant sought entitlement for weekly non-earner benefits and entitlement to one treatment plan for a psychological assessment. Adjudicator Lake found that the claimant was not entitled to the benefits in dispute. Adjudicator Lake noted that the claimant failed to prove on a balance of probabilities that she suffered from a psychological impairment or from chronic pain syndrome which would take her outside of the MIG. Adjudicator Lake found that the treatment plan was not reasonable and necessary as a result of the accident. In determining whether the claimant was entitled to ongoing non-earner benefits, Adjudicator Lake compared her pre- and post-accident activities of daily living. Adjudicator Lake concluded that the claimant did not identify what period of time she engaged in her pre-accident activities or what pre-accident activities were important to her. In cross-examination, the claimant also confirmed that at least seven months post-accident she was able to grocery shop, cook and sweep, and she was able to drive for five months post-accident. Adjudicator Lake concluded that the claimant had not met her onus of establishing that she suffered a complete inability to carry on a normal life.

Full decision here

TGP Analysis

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  • FILED UNDER Non-Earner Benefits, Minor Injury Guideline
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