Accident benefits claims for mental health assessment and dental treatment dismissed; applicant failed to meet burden of proof.
The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming the balance of costs for a mental health assessment and dental treatment.
The arbitrator dismissed the claims, finding that the insurer had already paid the maximum $2,000 permitted under the Schedule for the mental health assessment.
Regarding the dental treatment, the applicant failed to prove that the dental fractures were a direct result of the accident, and the arbitrator accepted the insurer's expert evidence that the disputed treatment was not reasonable and necessary.
The applicant was ordered to pay $1,500 in costs to the insurer.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesFeb 13, 2017