Insurer ordered to pay treatment benefits and special award for unreasonable delay; applicant denied expenses.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for treatment plans from a rehabilitation centre.
The insurer denied several treatment plans, relying on physiotherapy utilization guidelines rather than medical opinions, and delayed payments for initial treatments.
The arbitrator found the insurer unreasonably withheld and delayed payments, ordering payment of $1,285 for treatment and a special award of $1,223.63.
However, because the applicant flagrantly refused to comply with a pre-hearing order to produce pre-accident health records, the arbitrator denied the applicant's claim for arbitration expenses.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesApr 4, 2001
