Insurer ordered to pay reduced chiropractic and rehabilitation expenses after arbitrator finds fees excessive.
The applicants were injured in a motor vehicle accident and sought payment for chiropractic and rehabilitation expenses from their insurer under the Statutory Accident Benefits Schedule.
The insurer refused to pay the full amounts billed by the treatment facilities, arguing the treatments were excessive and the fees unreasonable.
The arbitrator found that the frequency and duration of treatments for the husband were excessive, while the wife's treatments were largely reasonable.
The arbitrator also significantly reduced the hourly rates and block fees charged by the facilities, finding them unsupported by professional guidelines or market rates.
The applicants were awarded partial payment of the claimed expenses plus interest, but their claim for a special award was dismissed.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesJun 5, 2000
