Tribunal partially approves accident benefits for occupational therapy and case management but denies further physiotherapy.
The applicant, who was deemed catastrophically impaired following a 2015 motor vehicle accident, sought payment for several treatment plans denied by the respondent insurer.
The Licence Appeal Tribunal found that the proposed physiotherapy services were not reasonable and necessary, as the applicant had reached maximum medical recovery and previous treatment yielded no functional gains.
The Tribunal partially approved the psychological services plan for the OCF-18 completion fee but denied administrative and planning costs.
The Tribunal approved the occupational therapy and case management plans, finding the requested hours for documentation and planning to be reasonable.
The applicant's claim for a special award was dismissed, as the insurer's conduct was not found to be unreasonable.
OLATOntario Licence Appeal TribunalApr 7, 2026
