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Insurer ordered to pay treatment plans and section 10 award due to non-compliant denial notices.
The Applicant sought statutory accident benefits following a motor vehicle accident.
The Respondent denied several treatment plans and prescription expenses.
The Tribunal found that the Applicant was not barred from proceeding to a hearing regarding an occupational therapy plan because the Respondent failed to provide medical reasons for requiring an insurer's examination.
The Tribunal ordered the Respondent to pay for the occupational therapy plan due to its non-compliant response, regardless of the funding limit.
The Tribunal also approved a neuropsychological assessment and certain prescription expenses as reasonable and necessary, but denied an MRI and SPECT scan.
An award of $1,448.86 was granted under section 10 of Regulation 664 for the Respondent's unreasonable withholding of benefits.
