Application for physiotherapy benefits dismissed; treatments not reasonable and necessary, and non-compliance claim lacked incurred expenses.
The applicant sought payment for three physiotherapy treatment plans following a motor vehicle accident.
The adjudicator found that the applicant failed to prove the treatments were reasonable and necessary, noting that the applicant's own family physician recorded that physiotherapy was not helping, and neither the applicant's nor the respondent's medical assessors recommended ongoing physiotherapy.
The applicant also argued entitlement based on the insurer's failure to provide timely notice under section 38(8) of the Schedule.
The adjudicator agreed the insurer was non-compliant but dismissed the claim because the applicant provided no evidence that the expenses were actually incurred during the period of non-compliance.
The application was dismissed.
OLATOntario Licence Appeal TribunalApr 24, 2026