Insurer's defective notices under s. 38(8) entitle applicant to incurred costs; several treatment plans approved.
The applicant sought statutory accident benefits following a motor vehicle accident.
The Licence Appeal Tribunal found that the insurer failed to provide adequate medical reasons in its notices denying certain treatment plans under s. 38(8) of the Schedule, entitling the applicant to incurred costs until proper notice is given.
The Tribunal also found three chiropractic treatment plans and one psychological treatment plan to be reasonable and necessary.
However, a second psychological treatment plan, a chronic pain assessment, and a cognitive assessment were deemed not reasonable and necessary.
The applicant's claim for an award under Regulation 664 was dismissed.
OLATOntario Licence Appeal TribunalApr 14, 2020