Treatment plans and special award granted where insurer ignored its own assessor; non-earner benefits denied.
The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits, medical benefits, and assessments.
The adjudicator dismissed the claim for non-earner benefits, finding the applicant's reduced capacity did not amount to a complete inability to carry on a normal life.
However, the adjudicator granted the disputed treatment and assessment plans, finding them reasonable and necessary given the applicant's pre-existing conditions that were exacerbated by the accident.
The adjudicator also ordered a special award under s. 10 of O. Reg. 664, finding the insurer unreasonably delayed removing the applicant from the Minor Injury Guideline despite its own assessor's opinion supporting the exacerbation of pre-existing impairments.
OLATOntario Licence Appeal TribunalAug 10, 2023
