Claim for statutory accident benefits partially granted; psychological services approved but other treatment plans denied.
The applicant sought various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.
The respondent insurer denied portions of several treatment plans for physiotherapy, occupational therapy, and psychological services, as well as transportation expenses.
The adjudicator found that the respondent's denial notices were compliant with section 38(8) of the Schedule.
The applicant failed to prove that the disputed physiotherapy, occupational therapy, and transportation expenses were reasonable and necessary.
However, the adjudicator found that the proposed psychological services were reasonable and necessary based on the treating psychologist's evidence of ongoing symptoms.
The claim for an award for unreasonable delay was dismissed.
OLATOntario Licence Appeal TribunalMay 2, 2025
