Insurer ordered to fund $25,000 dental treatment plan after accident exacerbated pre-existing periodontal disease.
The applicant sought $25,000 for a dental treatment plan following a motor vehicle accident.
The respondent insurer denied the claim, arguing the dental issues were caused by pre-existing periodontal disease rather than the accident.
The Tribunal applied the 'but for' test and found the accident was a necessary cause of the rapid deterioration of the applicant's dental health, relying on the opinion of the applicant's dental surgeon.
The Tribunal concluded the proposed treatment was reasonable and necessary, ordering the respondent to pay for the treatment plan plus interest.
OLATOntario Licence Appeal TribunalFeb 18, 2025
