Tribunal partially approves dental treatment plan, allowing composite restorations and one implant replacement.
The applicant sought medical benefits for dental work following a motor vehicle accident.
The insurer denied the treatment plan, relying on a section 44 assessment which concluded that only some of the proposed work was reasonable and necessary.
The Tribunal found that composite restorations for teeth 1.4 and 2.2 were reasonable and necessary, rejecting the applicant's request for porcelain crowns.
The Tribunal also approved an implant replacement for tooth 4.7, finding it more appropriate than the insurer's proposed extraction.
The claims for teeth 4.4 and 4.5 were dismissed as they were related to pre-existing wear and erosion.
OLATOntario Licence Appeal TribunalDec 11, 2018
