Kasik v Intact Insurance Company FSCO A11-000762

Facts:

On August 7, 2009, Eli Kasik was involved in a car accident and suffered a hit to the head. Immediately after the accident Kasik reported no serious pain until the following day. He visited Osler Rehabilitation where he received physiotherapy, massage, acupuncture, counselling and was given a number of exercises to do at home. At the onset Kasik received treatment three times per week; he was then reduced to twice and finally once a week. By March of 2010 the pain went away completely. At the time of the accident Kasik was renting a basement apartment with his friend Yehuda Kaufman. Kasik took on the responsibilities of performing all the housekeeping duties within their home because Kaufman was preoccupied with his studies. After the incident Kasik hired Eugene Krulevich as their housekeeper.

Issues:
The issues in this case are as follows:
1. Is Mr. Kasik entitled to receive compensation for the medical benefits provided by Osler Rehabilitation?
2. Is Mr. Kasik entitled to receive compensation for his housekeeper?
3. Is Mr. Kasik entitled to receive payment for an orthopaedic assessment?

Decision:
1. Mr. Kasik is not entitled to receive compensation for the medical benefits provided by Osler Rehabilitation
2. Mr. Kasik is not entitled to receive compensation for his housekeeper.
3. Mr. Kasik is not entitled to receive payment for an orthopaedic assessment.

Reasons for decision:

The adjudicator found that the applicant, Mr. Kasik did not meet the burden of proof as he did not demonstrate to the panel on a balance of probabilities that he was entitled to receive medical benefits pursuant to section 14 of the Schedule. Kasik did not provide any medical documents from his family physician or from the specialists who treated him. Moreover, Mr. Kasik did not call any of the doctors to testify to aid in supporting his claim. As a result, he fail prove that the treatments he received were both reasonable and necessary. The Respondent, however, provided a report from Dr. Richard Wolbeck who is an experience chiropractor. Dr. Wolbeck testified that he examined Mr. Kasik on October 22, 2009 and indeed, some of the treatments he received were necessary, however, not for a prolong period of time. He stated that Mr. Kasik told him that he was able to return to work immediately, and was also able perform his daily chores. Dr. Wolbeck concluded that the clinical findings and his interview with Mr. Kasik yield no signs of persistent musculoskeletal impairment.

Mr. Kasik is not entitled to receive compensation for his housekeeper because the evidence contradicts his testimony. He testified that he was living at 248 Arnold Avenue at the time of the accident. However, the Application for Benefits was dated on August 11, 2009 and shows 133 Cactus Avenue as his address. Moreover, the certification he received from the rehabilitation center on August 14, 2009 shows 245 Humberland Drive as his address. His housekeeper listed 115 Farmstead on the invoice. Mr. Kasik could not assert any rational explanations for these inconsistencies.

Lastly, Mr. Kasik was denied compensation for an orthopaedic assessment. Dr. White, a witness for the respondent reported that Mr. Kasik suffered soft tissue injury and after four months preceding all diagnosis and prognosis no further assessment was necessary. Moreover, Mr. Kasik did not provide any evidence to show why an orthopaedic assessment was required.

Conclusion:

Mr. Kasik was claiming monetary damages for loses he incurred as a result of a motor vehicle accident. However, the injuries he sustained were not life threatening, nor did they prevent him from performing his job and daily in home activities. He sought treatment from a Rehabilitation center that lasted only a few months, he hired a housekeeper to perform duties he was capable of taking on, and he sought further orthopaedic assessment four months after the injury. In my opinion the applicant did not sustain serious injuries that warranted prolong treatment, a hired housekeeper or further medical assessment. Mr. Kasik could not provide evidence to support his claim and more than likely this is because such evidence does not exist. He was not truthful in explaining the inconsistencies surrounding the usage of multiple addresses.

Rashida Forbes is a Paralegal student at Centennial College in Toronto studying professional communications with Omar Ha-Redeye.

1 Comment

  1. Hi there,
    After reading the details of this arbitration, who then becomes responsible for paying the medical services provided by Osler if Kasik has been deemeded ineligible?

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