Insurer ordered to pay for vision and occupational therapy; defective denial notice triggered mandatory payment.
The applicant sought statutory accident benefits following a motor vehicle accident.
The insurer denied treatment plans for optometric services and occupational therapy.
The Tribunal found that the applicant's impairments, including post-traumatic vision syndrome and headaches, were caused by the accident.
The Tribunal held that the optometric services were reasonable and necessary.
Furthermore, the Tribunal found that the insurer failed to provide proper medical reasons for denying the occupational therapy plan, violating s. 38(8) of the Schedule, and thus was required to pay for it under s. 38(11).
Both treatment plans were approved with interest.
OLATOntario Licence Appeal TribunalMay 14, 2020
