The applicant sought payment for four treatment plans for chiropractic services and other goods following a motor vehicle accident.
The respondent denied the plans based on insurer's examinations concluding the applicant had reached maximum medical recovery.
The Tribunal found that one treatment plan for $1,977.05 was reasonable and necessary to determine if maximum medical recovery had been reached, noting the insurer's assessors failed to review the family physician's clinical notes.
The remaining three treatment plans were dismissed due to a lack of contemporaneous complaints of pain or insufficient evidence justifying their necessity.
