Applicant held to MIG limits, but insurer ordered to pay treatment plans due to defective denial notices.
The applicant sought statutory accident benefits following a motor vehicle accident.
The Tribunal found that the applicant's injuries were predominantly minor and subject to the Minor Injury Guideline (MIG), rejecting expert evidence of psychological impairment and chronic pain syndrome.
However, the Tribunal ordered the respondent to pay for five disputed physiotherapy and psychological treatment plans because the respondent's denial letters contained boilerplate language that failed to provide sufficient medical reasons as required by s. 38(8) of the Schedule.
A claim for a chronic pain assessment was dismissed as the denial notice for that plan was compliant.
The Tribunal declined to order an award under s. 10 of Reg. 664.
OLATOntario Licence Appeal TribunalJan 8, 2025