Claims for medical benefits dismissed as applicant failed to prove treatments were reasonable and necessary.
The applicant sought medical benefits for physiotherapy, psychological treatment, and an orthopaedic assessment following a motor vehicle accident.
The adjudicator found that the insurer complied with the notice requirements under s. 38(8) of the Schedule.
The adjudicator dismissed the claims for physiotherapy, finding the applicant had reached maximum medical recovery and failed to exhaust collateral benefits.
The claim for an orthopaedic assessment was dismissed as it was available through OHIP.
The claim for further psychological treatment was dismissed as the applicant failed to prove the need for treatment beyond what the insurer had already partially approved.
OLATOntario Licence Appeal TribunalApr 3, 2020
