Claim for $800 in-home assessment dismissed as applicant failed to prove it was for Schedule purposes.
The applicant was injured in a motor vehicle accident and sought payment of $800 for an in-home assessment conducted by a kinesiologist.
The insurer denied the expense, arguing it was not reasonable or necessary and did not meet the criteria of section 24 of the Statutory Accident Benefits Schedule.
The arbitrator found that the applicant failed to prove the assessment was obtained "for the purpose of the Regulation," as there was no evidence connecting the referral to the accident or showing the report was used for rehabilitation or benefit entitlement.
The application for payment was dismissed.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesMar 6, 2001
