Three appellants appealed decisions of the Health Services Appeal and Review Board denying payment for out-of-country medical treatment because they did not obtain prior written approval from the General Manager of OHIP.
The Divisional Court held that while the Health Insurance Act and regulations do not expressly confer discretion to grant retroactive prior approval, such authority is necessarily implied in urgent circumstances where prior approval cannot be obtained.
The Court rejected arguments based on legitimate expectations, promissory estoppel, limitation periods against minors, and sections 7 and 15 of the Charter.
Two of the appeals were allowed and remitted to the Board to determine if urgent circumstances existed, while the third was dismissed.
