Application for accident benefits dismissed due to lack of credibility and insufficient objective medical evidence.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy and dental treatments.
The insurer denied the claims, arguing the treatments were not reasonable and necessary.
The arbitrator found the applicant's credibility to be lacking due to numerous discrepancies in her medical history and presentation.
The arbitrator concluded that the physiotherapy at the Rehab Centre was not reasonable, as the applicant had abandoned a previous clinic without cause and showed no significant improvement.
Furthermore, the arbitrator found insufficient objective evidence to support a diagnosis of a temporomandibular joint (TMJ) disorder caused by the accident, rejecting the applicant's dental treatment claim.
The application for benefits was dismissed.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesFeb 26, 2001
