Application for accident benefits dismissed as insurer's denials of treatment plans were procedurally compliant.
The applicant sought payment for a psychological assessment and a functional abilities evaluation following a motor vehicle accident.
The applicant argued that the insurer's denials were procedurally defective under s. 38(8) of the Schedule, triggering the 'shall pay' provision of s. 38(11).
The Tribunal found that the insurer's denials provided a principled rationale based fairly on the applicant's file, relying on insurer examination reports that concluded the applicant had no accident-related psychological impairment and that his physical injuries had resolved.
The application was dismissed, and claims for an award and interest were denied.
OLATOntario Licence Appeal TribunalOct 28, 2025