2 total
Application for accident benefits dismissed because the applicant failed to attend scheduled insurer's examinations.
The applicant sought statutory accident benefits for optometry services following a motor vehicle accident.
The respondent denied the treatment plan because the applicant failed to attend scheduled insurer's examinations (IEs) in Toronto and Brampton, citing the inconvenience of travelling from London.
The Tribunal found that the respondent made reasonable efforts to schedule the IEs at a convenient location, as there were no available specialists in the London area.
Because the applicant failed to attend the IEs without a reasonable excuse, she was barred from proceeding with her claim under s. 55 of the Statutory Accident Benefits Schedule.
The application was dismissed.
Chiropractic treatment plans approved for accident-related back pain; catastrophic assessment file review costs denied.
The applicant sought statutory accident benefits following a motor vehicle accident, including two treatment plans for chiropractic services and the outstanding balance for a catastrophic assessment.
The Tribunal found the chiropractic treatment plans reasonable and necessary to address the applicant's ongoing back pain, despite the presence of a non-cancerous tumour.
The Tribunal denied the outstanding balance for the catastrophic assessment, finding that individual file review costs are subsumed within the $2,000 funding limit.
The applicant's request for an award for unreasonable delay was dismissed, but interest was awarded on the approved treatment plans.
