Applicant removed from Minor Injury Guideline due to compelling evidence of pre-existing spinal conditions.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for chiropractic and physical therapy.
The insurer denied the treatment plan, arguing the applicant's injuries fell within the $3,500 limit of the Minor Injury Guideline (MIG).
The arbitrator found that while the applicant's impairments were predominantly minor injuries, she had documented pre-existing conditions, including scoliosis and degenerative disc disease, that constituted compelling evidence she could not achieve maximal recovery within the MIG limits.
The arbitrator ordered the insurer to pay the $3,487.60 treatment plan plus interest.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesAug 24, 2018
