Accident benefits denied as applicant's complete lack of credibility undermined claims for treatment and assessments.
The applicant sought statutory accident benefits for chiropractic treatment plans and in-home assessments following a 2012 motor vehicle accident.
The insurer denied the claims based on its medical assessments indicating the injuries were minor and required no further treatment.
The arbitrator dismissed the application in its entirety, finding the applicant completely lacking in credibility due to numerous inconsistencies, evasions, and denials regarding his significant pre-accident medical history.
The arbitrator concluded that the applicant's lack of credibility fundamentally undermined the reliability of his treating practitioners' recommendations, and the applicant failed to establish that the claimed benefits were reasonable and necessary.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesJul 19, 2016
