Functional Abilities Evaluation approved for catastrophic determination; remaining assessments and chiropractic treatments denied.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the respondent insurer.
The insurer partially denied the cost of a slate of catastrophic examinations and fully denied claims for chiropractic treatment.
The Licence Appeal Tribunal found that the Functional Abilities Evaluation and associated travel and completion fees were reasonable and necessary for the catastrophic impairment determination.
However, the Tribunal dismissed the claims for the remaining catastrophic assessments, finding them duplicative, and denied the chiropractic treatment plans because the applicant failed to demonstrate they were reasonable and necessary.
The claim for an award for unreasonable delay was also dismissed.
OLATOntario Licence Appeal TribunalNov 5, 2019
