Applicant removed from Minor Injury Guideline due to psychological impairment; insurer ordered to fund treatment.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits.
The respondent insurer denied funding for a psychological assessment and psychological services, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and its $3,500 limit.
The Licence Appeal Tribunal found that the applicant suffered a psychological impairment (including adjustment disorder and specific phobia) as a result of the accident, removing her from the MIG.
The Tribunal ordered the respondent to pay for the psychological services and a portion of the psychological assessment, noting the respondent failed to provide timely notice of its denial under s. 38(8) of the Schedule.
Interest on overdue payments was also awarded.
OLATOntario Licence Appeal TribunalJul 3, 2019
