Ongoing chiropractic treatment deemed reasonable and necessary supportive care; insurer ordered to pay outstanding expenses.
The applicant was injured in a motor vehicle accident and received statutory accident benefits.
The insurer refused to pay for chiropractic treatments after July 30, 1993, arguing they were no longer reasonable or necessary.
The arbitrator found that the ongoing chiropractic care constituted therapeutically necessary supportive care rather than elective maintenance care, given the physical demands of the applicant's work.
The arbitrator also ruled that while the insurer had no statutory right to require a medical examination for a claim involving only medical and rehabilitation benefits, the resulting medical report was admissible because the applicant attended voluntarily.
The insurer was ordered to pay the outstanding chiropractic and transportation expenses, plus the costs of the arbitration.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesDec 20, 1994
