Insurer ordered to pay reduced fee for EMG assessment found to be for the purpose of the Regulation.
The applicant sought payment of $1,284 for an EMG assessment and report prepared by a neurophysiology expert following a motor vehicle accident.
The insurer denied the claim, arguing it was not for the purpose of the Regulation and was covered by OHIP.
The arbitrator found the assessment was for the purpose of the Regulation and that the insurer failed to prove it was covered by OHIP.
However, the arbitrator found the fee unreasonable because the report was less than useful in developing a rehabilitation plan, and reduced the payable amount to $749.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesJun 10, 2004
