Arbitrator's award of medical benefits upheld, but cost of certain advocacy reports denied on appeal.
The insurer appealed an arbitrator's decision awarding the insured person medical benefits and the cost of assessments and reports, arguing the arbitrator erred in law by relying on the evidence of a clinic director with a financial interest in the outcome and poor record-keeping practices.
The insured person cross-appealed the dismissal of claims for translation services and the offsetting of a misdirected payment.
The Director's Delegate found that the arbitrator's findings of fact regarding the medical benefits were supported by the evidence and did not constitute an error of law.
However, the Director's Delegate allowed the appeal in part, finding the arbitrator erred in awarding section 24 expenses for certain reports that served only as advocacy or were prepared after the treatment cut-off date.
The cross-appeal was dismissed.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesDec 20, 2007