Application for accident benefits dismissed; applicant's injuries found to fall within the Minor Injury Guideline.
The applicant sought accident benefits following a motor vehicle accident, specifically claiming the cost of an attendant care assessment.
The insurer denied the claim on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The arbitrator found that the applicant failed to meet the onus of proving his impairments fell outside the MIG, preferring the insurer's expert evidence that the diagnosed radiculopathy was a sequelae of soft tissue injuries.
As the applicant was subject to the MIG, he was not entitled to attendant care benefits, rendering the assessment cost unreasonable and unnecessary.
The application was dismissed.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesNov 28, 2016