Statutory accident benefits denied; injuries fell within Minor Injury Guideline and surveillance contradicted reported limitations.
The applicant sought statutory accident benefits following a motor vehicle accident, including medical benefits for physiotherapy and the cost of disability certificates (OCF-3s).
The insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the treatments were not reasonable and necessary.
The adjudicator found that the applicant's injuries were predominantly minor and that she did not suffer from a pre-existing condition that would remove her from the MIG.
Relying on video surveillance that contradicted the applicant's reported limitations, the adjudicator concluded the treatment plans were not reasonable and necessary.
The claims for the OCF-3s were also dismissed as they were not requested by the insurer.
OLATOntario Licence Appeal TribunalJul 29, 2019
