Statutory accident benefits claims dismissed due to lack of medical necessity and applicant's credibility issues.
The applicant sought statutory accident benefits for psychological treatment, physiotherapy, housekeeping, and the cost of assessments following a motor vehicle accident.
The arbitrator dismissed all claims, finding that the applicant suffered from significant credibility issues, having failed to disclose a prior accident and pre-existing conditions to medical assessors.
The arbitrator relied on the findings of the insurer's examiners and the Med/Rehab DAC assessors, who concluded that further treatment was not reasonable or necessary.
The claims for housekeeping and assessment costs were also dismissed for lack of evidence and medical referral.
Due to the applicant's lack of success and her representative's problematic conduct during the hearing, the parties were ordered to bear their own arbitration expenses.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesFeb 8, 2002