Dr. Antonio Taverniti

The applicant sought payment for various medical and rehabilitation expenses following a motor vehicle accident.

The insurer denied the claims, arguing in part that the referring physician had an undisclosed conflict of interest regarding one of the treatment centres.

The arbitrator found that while the physician failed to disclose his ownership of the centre, the insurer had not previously approved the treatment plan, meaning the automatic exclusion under section 38(20) of the Schedule did not apply.

However, the arbitrator scrutinized the medical necessity of the treatments, awarding partial costs for acupuncture, the family physician's accident-related services, and certain diagnostic testing, while denying costs for structured physiotherapy.

The arbitrator also awarded overdue interest and dismissed the insurer's claim for repayment of disability benefits due to lack of proper notice.

The applicant sought ongoing statutory accident benefits following a motor vehicle accident, claiming physical and psychological disabilities prevented him from working as a superintendent.

The arbitrator found that the applicant suffered from chronic fatigue and psychological issues prior to the accident, stemming from previous torture in Turkey, which had already impaired his job performance.

Medical opinions supporting the applicant's claim were rejected because the experts were unaware of his pre-accident condition.

The arbitrator concluded the accident did not significantly contribute to the applicant's disability, denying further weekly benefits and the insurer's claim for repayment, but awarded reimbursement for a medical report.