Applicant awarded ongoing post-104 week IRBs and a $2,800 penalty for insurer's unreasonable withholding of medical reports.
The applicant was injured in a motor vehicle accident and sought post-104 week income replacement benefits (IRBs) and a physiotherapy treatment plan.
The respondent terminated IRBs based on insurer examinations concluding her physical injuries had resolved.
The Tribunal found that the accident was a necessary cause of the applicant's chronic pain syndrome, which rendered her completely unable to engage in suitable employment.
The Tribunal awarded ongoing IRBs and interest.
The physiotherapy treatment plan was denied as the applicant had reached maximum medical recovery.
The Tribunal also ordered a $2,800 award against the respondent under Regulation 664 for unreasonably failing to provide the applicant's chronic pain assessment report to its own medical examiners, which prejudiced the assessment process.
OLATOntario Licence Appeal TribunalApr 28, 2023
