Applicant removed from Minor Injury Guideline due to psychological injuries; insurer penalized for late denial.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits.
The insurer determined the injuries fell within the Minor Injury Guideline (MIG) and denied several treatment plans.
The Tribunal found that the applicant sustained psychological injuries, including an adjustment disorder with mixed anxiety and depressed mood, which removed him from the MIG.
The Tribunal ordered payment for a psychological assessment plan and a chiropractic treatment plan that the insurer had failed to deny within the required timelines.
A second chiropractic treatment plan was found not reasonable and necessary.
OLATOntario Licence Appeal TribunalDec 17, 2021
