The applicant was injured in a motor vehicle accident and sought statutory accident benefits for various medical treatments, medications, and the cost of reports and assessments.
The insurer denied the claims based on a DAC assessment that concluded further treatment was not reasonable or necessary.
The arbitrator found that the applicant's recovery was prolonged by pre-existing conditions and psychological issues, and that the multi-disciplinary treatments provided were reasonable and necessary up to a certain date.
The arbitrator awarded partial payment for the treatments and reports, and full payment for the medications.
The claim for a special award was dismissed as the insurer's reliance on its medical reports was not unreasonable.
The applicant was awarded interest and arbitration expenses.
