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J.J.X. v. Aviva General Insurance (19-002558)

  • April 22, 2020

The claimant sought a determination that his injuries were outside of the MIG, and entitlement to medical benefits proposed in three physiotherapy treatment plans, a chiropractic treatment plan, and a psychological assessment. The claimant also sought entitlement to non-earner benefits. Adjudicator Grant found that the claimant’s injuries were predominantly minor and fell within the MIG. He found there were no records from any family physician to support the physical injury claims made by the claimant, and the medical evidence that was submitted confirmed that the claimant’s injuries were minor. As the MIG limit of $3,500 in medical and rehabilitation benefits had already been exhausted, it was unnecessary to determine whether the treatment plans in dispute were reasonable and necessary. Adjudicator Grant also found that the claimant had not met his onus of establishing that he suffered a complete inability to carry on a normal life and was therefore not entitled to non-earner benefits. He noted the medical evidence produced showed that the claimant returned to substantially all of his pre-accident activities, including attending the gym twice per week, cooking, and returning to school within a few days of the accident.

Full decision here

TGP Analysis

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  • FILED UNDER Non-Earner Benefits, Minor Injury Guideline
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