Insurer ordered to pay occupational services treatment plan due to non-compliant denial notice; other benefits denied.
The applicant sought entitlement to various statutory accident benefits following a motor vehicle accident, including multiple treatment plans and attendant care benefits.
The Tribunal found that the applicant failed to meet her onus to prove that the majority of the treatment plans and the attendant care benefits were reasonable and necessary.
However, the Tribunal ordered the respondent to pay $2,013.20 for occupational services because the respondent's denial notice failed to provide sufficient medical reasons as required by section 38(8) of the Schedule.
Claims for a section 10 award and the cost of an OCF-3 were dismissed.
OLATOntario Licence Appeal TribunalOct 9, 2025
