Insurer ordered to pay for treatment plans and special awards due to procedural non-compliance.
The applicants were injured in a motor vehicle accident and sought payment for chiropractic treatment and housekeeping expenses from their insurer.
The arbitrator found the applicants' evidence regarding the necessity of the treatment and housekeeping services to be implausible and unreliable.
However, because the insurer failed to comply with the mandatory procedures under section 38(12) of the Schedule for rejecting a treatment plan, the arbitrator ordered the insurer to pay for the second treatment plans submitted by the applicants.
The arbitrator also awarded each applicant a $500 special award due to the insurer's procedural non-compliance, but denied the claims for housekeeping expenses and ordered each party to bear their own arbitration expenses.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesFeb 20, 2007