Arbitration for medical benefits dismissed due to applicant's lack of credibility and insufficient medical evidence.
The applicant sought arbitration after the insurer denied his claim for medical benefits for treatment plans totaling $2,589 following a motor vehicle accident.
The arbitrator found the applicant lacked credibility, noting significant inconsistencies between his testimony of debilitating pain and the clinical notes of his long-time family doctor, which made no mention of the accident or musculoskeletal complaints.
The arbitrator gave no weight to the evidence of the applicant's chiropractors, as one failed to provide clinical notes or a reasonable explanation for his conclusions, and the other merely repeated progress reports without examining the applicant.
The arbitration was dismissed, and the claims for medical benefits and a special award were denied.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesAug 28, 2007
