Insurer ordered to pay for nerve blocks and a special award, but botox claim denied as experimental.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for nerve block injections, botox injections, massage treatments, and a special award for delayed payment of psychological and vocational assessments.
The arbitrator found that the nerve block injections were a reasonable and necessary treatment for short-term pain relief, ordering the insurer to pay the $800 cost.
However, the claim for botox and massage was dismissed, as the arbitrator accepted expert evidence that botox is an experimental treatment for chronic pain.
The arbitrator also awarded a special award of $1,170 against the insurer for unreasonably denying psychological treatment without requesting a Designated Assessment Centre (DAC) assessment, despite the insurer settling the claim shortly before the hearing.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesDec 20, 2001
