Applicant remains in MIG, but treatment plans payable due to insurer's defective denial letters.
The applicant sought statutory accident benefits following a motor vehicle accident.
The Tribunal found that the applicant failed to prove her injuries warranted removal from the Minor Injury Guideline (MIG), as the medical evidence did not establish chronic pain with functional impairment or a psychological condition.
However, the Tribunal ordered the respondent to pay for three disputed treatment plans because the respondent failed to prove it delivered valid denial letters within the required 10 business days under s. 38(8) of the Schedule.
The applicant's claim for an award under s. 10 of Reg. 664 was dismissed.
OLATOntario Licence Appeal TribunalOct 24, 2023