Dr. Domenic Minella

The applicant sought various medical and rehabilitation benefits, as well as the cost of several assessments, following a motor vehicle accident.

The respondent insurer denied the treatment plans.

The Tribunal found that the applicant failed to prove the disputed treatment plans and assessments were reasonable and necessary.

The Tribunal preferred the evidence of the respondent's medical assessors, who reviewed the applicant's complete medical records and found that further facility-based treatment would not lead to significant improvements and that the applicant's psychological issues were largely pre-existing or subclinical.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a motor vehicle accident.

The Tribunal found that the Minor Injury Guideline did not apply due to the insurer's failure to provide proper notice under subsection 38(8) of the Schedule.

However, the applicant's claims for attendant care benefits, physiotherapy, and chronic pain treatments were dismissed as the expenses were either not incurred or not reasonable and necessary.

The Tribunal ordered the insurer to pay for assistive devices and an attendant care assessment due to procedural breaches, and granted a 50% special award under O. Reg. 664 for unreasonably withholding payments.