Insurer ordered to pay for chronic pain program and orthopaedic assessment; special award denied.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a chronic pain management program and an orthopaedic assessment.
The respondent insurer denied the treatment plans, arguing they were not reasonable or necessary.
The Licence Appeal Tribunal found the applicant's medical evidence, which included diagnoses of chronic pain syndrome and recommendations for multidisciplinary treatment, to be more persuasive than the insurer's assessments.
The Tribunal ordered the respondent to pay for the chronic pain program and the orthopaedic assessment, along with interest on incurred expenses.
However, the Tribunal dismissed the applicant's claim for a special award under Regulation 664, finding no evidence that the insurer acted unreasonably or in bad faith.
OLATOntario Licence Appeal TribunalNov 24, 2017