Dr. Bruce Makos

The applicant was injured in a motor vehicle accident and sought payment for medical benefits and assessment costs from his insurer, related to treatments at a clinic.

The insurer disputed the amounts billed, arguing they were excessive and did not reflect the actual treatments provided.

The arbitrator found the applicant's evidence unreliable and noted the clinic's failure to produce key documents.

The arbitrator largely accepted the insurer's position on the appropriate fees for the services rendered, awarding a reduced amount for massage therapy, adhesive pads, and one reassessment, while denying the costs of an in-home assessment and other reports.

Both parties' claims for arbitration expenses were dismissed.

The applicant was injured in a motor vehicle accident and claimed statutory accident benefits, including income replacement, rehabilitation, housekeeping, and dependant care benefits.

The insurer terminated benefits based on a disability DAC assessment by a chiropractor.

The arbitrator found that the applicant suffered from a severe TMJ disorder, chronic pain, and depression, rendering her substantially unable to perform the essential tasks of her pre-accident employment as a travel consultant.

The arbitrator awarded the claimed benefits and ordered the insurer to pay a $30,000 special award for unreasonably withholding benefits, noting the insurer's reliance on an assessor lacking expertise in TMJ disorders and its failure to re-evaluate its position in light of overwhelming medical evidence.

The applicant was injured in a motor vehicle accident and sought payment for chiropractic and rehabilitation expenses incurred after the insurer terminated benefits based on a Designated Assessment Centre report.

The arbitrator found that the applicant was motivated to exercise on her own and did not require the supervised rehabilitation program, which was billed at an excessive hourly rate.

Furthermore, the arbitrator found no persuasive evidence that the continued chiropractic treatment was reasonable or necessary, noting that the treating chiropractor had not discussed the need for further treatment with the applicant.

The application for arbitration was dismissed.