Lali Antony v. Belair Insurance Company Inc., 2025 CanLII 135606

Citation: Antony v. Belair Insurance Company Inc, 2025 ONLAT 24-003540/AABS

Licence Appeal Tribunal File Number: 24-003540/AABS

In the matter of an application pursuant to subsection 280(2) of the Insurance Act, RSO 1990, c I.8, in relation to statutory accident benefits.

Between:

Lali Antony Applicant

and

Belair Insurance Company Inc. Respondent

DECISION

ADJUDICATOR: Kathleen Wells

APPEARANCES:

For the Applicant: Kim Mohammed-Sieudhan, Paralegal

For the Respondent: Robbie Brar, Counsel

HEARD: By way of written submissions

OVERVIEW

1Lali Antony, the applicant, was involved in an automobile accident on June 13, 2022, and sought benefits pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (including amendments effective June 1, 2016) (the “Schedule”). The applicant was denied benefits by the respondent, Belair Insurance Company Inc., and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.

ISSUES

2The issues in dispute are:

1. Is the applicant entitled to $621.56 ($1,763.52 less $1,141.96 approved) for Physiotherapy Services, proposed by Alma Rehab Inc. in a treatment plan/OCF-18 (“treatment plan”) dated September 12, 2022?
2. Is the applicant entitled to $3,244.58 for Physiotherapy Services, proposed by Alma Rehab Inc. in a treatment plan dated November 21, 2022?
3. Is the applicant entitled to $2,912.56 for Physiotherapy Services, proposed by Alma Rehab Inc. in a treatment plan dated April 3, 2023?
4. Is the applicant entitled to the assessments proposed by Ontario Independent Assessment Centre Inc., as follows: i. $1,850.00 for an FAE Assessment, in a treatment plan dated November 11, 2022; ii. $2,200.00 for an In-Home and Attendant Care Assessment, in a treatment plan dated November 14, 2022? iii. $1,950.00 for a Functional Cognitive Assessment, in a treatment plan dated November 30, 2022? iv. $2,350.00 for an Orthopaedic Assessment, in a treatment plan dated December 1, 2022? v. $2,350.00 for a Chronic Pain Assessment, in a treatment plan dated December 22, 2022? vi. $2,350.00 for a Neurological Assessment, in a treatment plan dated January 13, 2023?$2,000.00 for a Biopsychosocial Assessment, in a treatment plan dated December 21, 2022?
5. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
6. Is the applicant entitled to interest on any overdue payment of benefits?

RESULT

3I find that:

1. The applicant is not entitled to the treatment plans in dispute.
2. As no payments are owing, no interest is due.
3. The application is dismissed.

ANALYSIS

4To receive payment for a treatment and assessment plan under s. 15 and 16 of the Schedule, the applicant bears the burden of demonstrating on a balance of probabilities that the benefit is reasonable and necessary as a result of the accident. To do so, the applicant should identify the goals of treatment, how the goals would be met to a reasonable degree and that the overall costs of achieving them are reasonable.

5The purpose of an assessment is to determine whether a condition exists. For an insured, they bear the onus to demonstrate that there are grounds on which to believe that a condition exists that would warrant further investigation by way of an assessment.

Is the applicant entitled to $621.56 ($1,763.52 less $1,141.96 approved) for physiotherapy services in a treatment plan dated September 12, 2022?

6The respondent submits that the treatment plan for the remaining balance of $621.56 ($1,763.52 less $1,141.96 approved) for physiotherapy services set out is no longer at issue because the respondent has approved this treatment plan in full. The respondent submitted a letter dated October 1, 2024 approving the treatment plan dated September 12, 2022 for the full amount of $1,763.52.

7As the applicant did not provide any submissions in reply to rebut the respondent’s submissions with respect to this treatment plan, and neither party submitted any other correspondence, I find that the respondent has approved the treatment plan, and the applicant’s submissions with respect to the September 12, 2022 treatment plan are moot.

Is the applicant entitled to $3,244.58 for physiotherapy services in a treatment plan dated November 21, 2022?

8I find that the applicant has not established on a balance of probabilities that the treatment plan dated November 21, 2022 is reasonable and necessary.

9The goals of the treatment plan, prepared by Dr. Roger Singh, chiropractor, of Alma Rehab Inc. are: pain reduction, increased range of motion, increase in strength, and a return to the activities in daily living. The treatment plan identifies the applicant’s physical injuries as sprains and strains to the lumbar spine and knees. It seeks a total of $3,244.18, which includes 18 sessions each of physiotherapy, chiropractic treatment, and exercise, 9 sessions of massage therapy, and an unspecified item of exercise equipment, in addition to a $200.00 fee for completing the OCF-18 form.

10The applicant submits that the treatment plan is reasonable and necessary because the applicant suffered from pain in his neck, back and both knees as a result of his accident-related injuries. The applicant relies on the OCF-3 of Dr. Bohdan Osoba, chiropractor, dated June 16, 2022, the clinical notes and records (“CNRs”) of the William Osler Health Centre emergency department, the CNRs of the applicant’s family doctor Dr. Ruma Chowdhury, and the CNRs of Alma Rehab Inc. The applicant further relies on the s. 25 psychological assessment of Dr. Konstantinos Papazoglou, psychologist, dated December 6, 2022.

11The respondent argues that the applicant has not met his onus to prove that the treatment plan is reasonable and necessary, and relies on the s.44 insurer examination (“IE”) general practitioner report, dated January 6, 2023, and May 16, 2023 and July 7, 2023 IE addendum paper review reports of Dr. Alan Kugler, physician, who diagnosed the applicant with soft tissue injuries to the cervical spine, and lumbar spine, and knee pain, and opined that there were no further investigations or treatment necessary for the applicant’s recovery. The respondent also relies on the January 23, 2023 IE report of Dr. Ato Sekyi-Otu, orthopaedic surgeon, who opined that the applicant had “excellent range of motion in all of his joints.”

12The respondent further submits that the applicant’s knee pain predated the accident because he complained to Dr. Chowdhury of having had knee pain for four months on May 14 and May 21, 2022, within a month before the accident, and was sent for imaging which revealed no degenerative changes. However, I find that the evidence reveals that the respondent’s IE assessors opined that the applicant had sustained contusions to his knees as a result of the accident.

13I find that the evidence does not support a finding that the treatment plan is reasonable and necessary. The CNRs of the William Osler Health Centre emergency department reveal that the applicant complained of chest pain immediately following the accident, on June 13, 2022, a laceration was noted on the applicant’s left knee. The applicant was sent for x-ray imaging of his chest, which returned no acute findings, and was discharged with advice to follow up with his family doctor. The following day, the applicant complained of neck, upper back and chest pain to Dr. Ruma Chowdhury, who also noted that the applicant’s left knee was tender, and diagnosed the applicant with musculoskeletal strains and suggested that physiotherapy could be considered if his symptoms persisted. Dr. Chowdhury’s CNRs reveal no further visits with respect to the applicant’s accident-related physical injuries, no prescriptions for pain medication, and no referral for physiotherapy.

14Dr. Osoba’s OCF-3 identifies that the applicant has a substantial inability to carry out his housekeeping and home maintenance services, and that his period of disability is expected to be 9-12 weeks. He recommends a functional abilities evaluation and a psychological assessment. While the applicant reported some limitations to his participation in household chores to Dr. Papazoglou, during his November 22 psychological assessment, the applicant has not directed me to evidence that corroborates his reports about his functional abilities to Dr. Osaba and Dr. Papazoglou.

15The evidence reveals that the applicant attended Alma Rehab Inc for physiotherapy services between June 2022, and May 2023. The CNRs of Alma Rehab indicate that by November 14, 2022, when the treatment plan was submitted, the CNRs are focussed on the applicant’s knee pain, with occasional references to intermittent lower back pain.

16While I agree with the applicant that pain relief is a valid goal of treatment, and I accept that the applicant suffered ongoing intermittent lower back and knee pain, the applicant has not directed me to any evidence of the impact on his ongoing pain from the therapy he has undergone, or how further treatment will serve to alleviate his pain or meet other goals of the treatment plan. The treatment plan indicates that the applicant’s pain and inflammation should be co-managed with his physician, however, the applicant has not directed me to any evidence that he has seen Dr. Chowdhury for pain since immediately following the accident.

17Further, in his January 6, 2023 IE report, Dr. Kruger noted that the applicant told him that his pain to his cervical and lumbar spine were ameliorated by rest, and that he only experienced knee pain when he was using the stairs. I find that the applicant’s reports to Dr. Kruger are not consistent with the applicant achieving pain relief from his physiotherapy treatments.

18Additionally, the applicant has not made any submissions as to whether the overall cost of the treatment plan is reasonable and necessary.

19For these reasons, I find that the applicant has not met his onus to prove on a balance of probabilities that the treatment plan dated November 21, 2022 is reasonable and necessary.

20Accordingly, the applicant is not entitled to $3,244.58 for physiotherapy services in the treatment plan dated November 21, 2022.

Is the applicant entitled to $2,912.56 for physiotherapy services in a treatment plan dated April 3, 2023?

21I find that the applicant has not established on a balance of probabilities that the treatment plan dated April 3, 2023 is reasonable and necessary.

22The goals of the treatment plan, prepared by Dr. Bohdan of Alma Rehab Inc., are: pain reduction, increase in strength, increased range of motion, prevention of chronicity, and to reassure the patient. It seeks $2,912.52 for 16 sessions each of physiotherapy, chiropractic treatment, and exercise, 8 sessions of massage therapy, and an unspecified item of exercise equipment as well as a $200.00 fee for the completion of the OCF-18 form.

23The applicant submits that the treatment plan is reasonable and necessary to treat the applicant’s ongoing pain and submits that the applicant continued to complain of knee pain after the treatment plan was submitted.

24The respondent contends that the applicant has not met his onus to prove that the treatment plan is reasonable and necessary, and relies on the IE paper review of Dr. Kruger, and the January 23, 2022 orthopaedic IE report of Dr. Sekyi-Otu.

25I find that the evidence does not establish that the treatment plan is reasonable and necessary, because the applicant has not directed me to any contemporaneous medical evidence to corroborate the applicant’s complaints of pain, or any evidence that the applicant has been referred for physiotherapy by a treating physician. In addition, in his May 16, 2023 IE paper review, Dr. Kruger maintained his earlier diagnosis of soft tissue injuries to the neck, lower back, and knees, and opined that the treatment plan was not reasonable and necessary. Further, in his January 23, 2023 orthopaedic IE assessment, Dr. Sekyi-Otu opined that the applicant had “excellent range of motion” in all of his joints.

26Additionally, the applicant makes no submissions with respect to whether the overall cost of the treatment plan is reasonable and necessary.

27As a result, I find that the applicant has not met his onus to prove on a balance of probabilities that the April 3, 2023 treatment plan is reasonable and necessary.

28Accordingly, the applicant is not entitled to $2,912.56 for physiotherapy services in the treatment plan dated April 3, 2023.

Is the applicant entitled to $1,850.00 for an FAE Assessment, in a treatment plan dated November 11, 2022?

29I find that the applicant has not established on a balance of probabilities that an FAE is warranted.

30The treatment plan, dated November 11, 2022 was prepared by Marco Curcio, chiropractor, of Ontario Independent Assessment Centre Inc. It seeks $1,850.00 which consists of $1,500.00 for an FAE, $200.00 to complete the OCF-18 form, and $150.00 for transportation for the applicant.

31The applicant submits that the FAE is warranted because the applicant has limitations in prolonged static postures, lifting and carrying heavy objects, and bending and twisting.

32The respondent argues that the applicant has not met his onus to prove that the FAE assessment is warranted. It relies on the January 6, 2023 IE of Dr. Kruger, who opined that the treatment plan was not reasonable and necessary.

33I agree with the respondent. I find that the evidence does not establish that there is reason to believe that an FAE is warranted. The additional comments section of the treatment plan reveals that the treatment plan is based on a review of document and lists only the June 16 OCF-3 as reviewed. As noted above, the OCF-3 indicates that the applicant has a substantial inability to carry out his household and maintenance services, estimates a 9-12 week recovery, and recommends an FAE. However, the treatment plan is dated November 22, 2022, more than five months later, and references no contemporaneous medical evidence.

34The only submissions with respect to the applicant’s function relate to the applicant’s self-reports to Dr. Papazoglou in his December 6, 2022 s.25 psychological report. Dr. Papazoglou identified that the applicant was restricted from bending and twisting, carrying heavy items, and attending to most household chores, which is inconsistent with the applicant’s reports to Dr. Kruger at his December 22, 2022 IE, two weeks later. As Dr. Papazoglou is a psychologist, and physical medicine is outside of his practice area, and he did not conduct a physical examination of the applicant, I assign his report less weight.

35I assign more weight to Dr. Kruger’s IE report, because he conducted an in-person interview, a physical examination, and a review of the applicant’s medical records. As noted by the respondent, the applicant told Dr. Kruger that he had resumed most of his household chores, was independent with his personal care, and had returned to work as a security guard one week after the accident. His job entailed carrying objects weighing 20 lbs, and sitting and walking for extended periods. Dr. Kruger opined that the applicant’s physical examination was consistent with his reported complaints.

36For these reasons, I find that the applicant has not met his onus to prove on a balance of probabilities that the treatment plan for an FAE is reasonable and necessary.

37Accordingly, the applicant is not entitled to $1,850.00 for an FAE in the treatment plan submitted November 11, 2022.

Is the applicant entitled to $2,200.00 for an In-Home and Attendant Care Assessment, in a treatment plan submitted November 14, 2022?

38I find that the applicant has not established on a balance of probabilities that an in-home and attendant care assessment is warranted.

39The treatment plan, submitted November 14, 2022, was prepared by Dr, Bhawandeep Katora, occupational therapist, of Ontario Independent Assessment Centre Inc. It seeks $2,200.00, including $2,000.00 for an attendant care assessment and $200.00 for the completion of the OCF-18 form.

40The applicant submits that an attendant care assessment is warranted because the applicant has difficulties with many household chores, including meal preparation, dishwashing, and laundry, and that an assessment will determine the extent of the applicant’s functional limitations.

41The respondent argues that the applicant has not met his onus to prove that an attendant care assessment is warranted and relies on the occupational therapy in-home IE report of Jag Dhirayain, registered occupational therapist, dated January 30, 2023. Mr. Dhirayain conducted an in-home assessment, interview of the applicant, functional testing, and observation and opined that an in-home and attendant care assessment was not reasonable and necessary.

42I agree with the respondent. I find that the evidence does not establish on a balance of probabilities that an in-home and attendant care assessment is warranted. The treatment plan identifies multiple injuries that are not corroborated by contemporaneous medical evidence, and asserts that the severity of the applicant’s injuries indicate a need for extensive assistance with the applicant’s activities of daily living. However, the additional comments section of the treatment plan indicates that Dr. Katora was requested to review documents in order “to establish the necessity of a possible conduction of an in-home and attendant care assessment.” Dr. Katora did not indicate which documents were reviewed or identify any specific information about the applicant’s condition that indicated that the proposed assessment was reasonable and necessary.

43Further, the applicant did not direct me to any recommendation from a treatment provider, or contemporaneous medical or other evidence to corroborate that there was reason to believe that the assessment was warranted.

44As a result, I find that the applicant has not met his onus to prove on a balance of probabilities that the in-home and attendant care assessment is reasonable and necessary.

45Accordingly, the applicant is not entitled to $2,200.00 for an in-home and attendant care assessment in the treatment plan submitted November 14, 2022.

Is the applicant entitled to $2,350.00 for an Orthopaedic Assessment, in a treatment plan dated December 1, 2022?

46I find that the applicant has not established on a balance of probabilities that the treatment pan is reasonable and necessary.

47The treatment plan, dated December 1, 2022, was prepared by Dr. Gilbert Yee, physician, of Ontario Independent Assessment Centre Inc. It seeks $2,350.00, including $2,000,00 for an orthopaedic assessment, $200.00 to complete the OCF-18 form, and $150.00 in transportation costs for the applicant.

48The applicant submits that an orthopaedic assessment is necessary to assess the applicant’s neck, upper back, and chest pain, and formulate recommendations.

49The respondent argues that the applicant has not met his onus to prove that an orthopaedic assessment, and relies on the Dr. Sekyi-Otu’s January 23, 2023 orthopaedic IE report in which Dr. Sekyi-Otu opined that the treatment plan for an orthopaedic assessment was not reasonable and necessary.

50I find that the evidence does not establish that an orthopaedic assessment is warranted. The applicant has not directed me to contemporaneous medical evidence to support the treatment plan, which references only Dr. Chowdhury’s CNR’s from June 14, 2022, and the report of the applicant’s chest x-ray taken on June 13, 2022 as documents reviewed for the treatment plan. Further, the applicant’s submissions that he is experiencing neck, chest, and upper back pain are not consistent with the applicant’s complaints of neck pain, lower back pain and knee pain to his IE assessors in the 6 weeks following the submission of the treatment plan on December 1, 2022.

51In his January 23, 2023 IE report, Dr. Sekyi-Otu diagnosed the applicant with uncomplicated myofascial sprains and strains to his cervical and lumbar spines, and contusions to the knees. Dr Sekyi-Otu opined that the applicant had an “excellent” range of motion in his cervical, thoracic, and lumbar spine, and in the major joints in both his upper and lower extremities. Dr. Sekyi-Otu further opined that there was no exacerbation of arthritis, and no ongoing impairment as a result of the accident. Finally, he opined that the treatment plan for an orthopaedic assessment was not reasonable and necessary.

52For these reasons, I find that the applicant has not met his burden to prove that the treatment plan is reasonable and necessary.

53Accordingly, the applicant is not entitled to $2,350.00 for the treatment plan for an orthopaedic assessment submitted on December 1, 2022.

Is the applicant entitled to $2,350.00 for a Chronic Pain Assessment, in a treatment plan submitted December 22, 2022?

54I find that the applicant has not established on a balance of probabilities that a chronic pain assessment is warranted.

55The treatment plan, submitted on December 22, 2022, was prepared by Kahl Efala, physician, of Ontario Independent Assessment Centre Inc. It seeks $2,350.00, including $2,000.00 for a chronic pain assessment, $200.00 for the completion of the treatment plan, and $150.00 for transportation for the applicant.

56The applicant submits that the applicant requires a chronic pain assessment to address his persisting chest, neck, and upper back pain.

57The respondent submits that the applicant has not met his onus to prove that the chronic pain assessment is warranted, and relies on Dr. Kruger’s January 6, 2023 IE report.

58The applicant has not directed me to contemporaneous medical evidence that the applicant was experiencing chest or upper back pain at the time the treatment plan was submitted, and the applicant’s submissions with respect to his pain are not consistent with his self reports to his assessors. Further, the treatment plan refers to Dr. Chowdhury’s June 14, 2022 CNR as well as Dr. Papazoglou’s s.25 report, which identifies pain locations which are inconsistent with each other and also inconsistent with the injuries identified in the treatment plan.

59The Tribunal has long held that a treatment plan must be supported by objective and corroborating medical evidence. In the present case, the applicant has not directed me to evidence to support his submissions.

60As a result, I find that the applicant has not met his onus to prove that the treatment plan is reasonable and necessary.

61Accordingly, the applicant is not entitled to $2,350.00 for a chronic pain assessment in the treatment plan submitted December 22, 2022.

Is the applicant entitled to $2,350.00 for a Neurological Assessment, in a treatment plan dated January 13, 2023?

62I find that the applicant has not established that the treatment plan for a neurological assessment is warranted.

63The treatment plan, submitted January 13, 2023, was prepared by Narmin Shirin, nurse, seeks $2,350.00, including $2,000.00 for a neurological assessment, $200.00 for the completion of the treatment plan, and $150.00 for transportation for the applicant.

64The applicant submits that the treatment plan is reasonable and necessary because the applicant has been experiencing headaches since the accident, and a neurological assessment will assist with a diagnosis and treatment planning.

65The respondent argues that a neurological assessment is not warranted because Dr. Galit Kleiner, neurologist, opined in his January 26, 2023 neurological IE report that the applicant did not sustain a neurological injury as a result of the accident.

66In the additional comments section of the treatment plan, Ms. Shirin summarizes a neurological pre-screening questionnaire which the applicant completed on November 22, 2022. The applicant identified intermittent moderate headaches, light sensitivity and dizziness. He also identified intermittent mild pain in his neck which radiates to both shoulders, and intermittent moderate lower back pain which radiates through the back of his legs. The applicant did not direct me to any medical evidence to corroborate the treatment plan.

67I am persuaded by Dr. Kleiner’s IE report. He conducted an in-person examination on January 13, 2023 which consisted of a review of the applicant’s medical records, an interview, and a physical examination. At the IE, the applicant complained of bilateral knee pain, which is worse when he uses the stairs. He also complained of occasional low back pain which he rated at a 5/10 and told Dr. Kleiner that it had no radicular features. Finally, he complained of headaches, which had “no associated features.”

68Dr. Kleiner opined that the applicant’s neurological examination was normal, that he had no neurological complaints, and does not have a neurological impairment.

69As the applicant did not direct me to any medical or other evidence in support of the treatment plan, I find that the applicant did not meet his onus to prove that the treatment plan is reasonable and necessary.

70Accordingly, the applicant is not entitled to $2,350.00 for a neurological assessment in a treatment plan submitted.

Is the applicant entitled to $1,950.00 for a Functional Cognitive Assessment, in a treatment plan dated November 30, 2022?

71I find that the applicant has not established that a functional cognitive assessment is warranted.

72The treatment plan submitted on November 30, 2022 was prepared by Julian Amchislavsky, occupational therapist of Ontario Independent Assessment Centre Inc. It seeks $1,950.00 for a functional cognitive assessment including $1,600.00 for the assessment, $200.00 to complete the OCF-18 form, and $150.00 for transportation services.

73The applicant submits that the functional cognitive assessment is warranted because the applicant suffers from anxiety, restlessness and sleep deprivation as a result of his accident-related injuries.

74The respondent argues that the applicant has not met his onus to prove that the treatment plan is reasonable and necessary, and relies on Dr. Kleiner’s February 17, 2023 IE report. Dr. Kleiner opined that the treatment plan was not reasonable and necessary because the applicant did not have any cognitive complaints and he did not have a neurological impairment. The applicant told Dr, Kleiner that he had been distracted “early on” because he was having nightmares, but that it had improved.

75As the applicant has not directed me to any contemporaneous medical evidence in support of the treatment plan, I find that he has not met his onus to prove that the treatment plan is reasonable and necessary.

76Accordingly, the applicant is not entitled to $1,950.00 for the functional cognitive assessment submitted on November 30, 2022.

Is the applicant entitled to $2,000.00 for a biopsychosocial assessment in a treatment plan submitted December 21, 2022?

77I find that the applicant has not established that a biopsychosocial assessment is warranted.

78The treatment plan submitted on December 21, 2022 was prepared by Marco Curcio, chiropractor of Ontario Independent Assessment Centre Inc. It seeks $2,000.00, including $1,800.00 for a biopsychosocial assessment and $200.00 to complete the OCF-18 form.

79The applicant submits that the biopsychosocial assessment is warranted because the applicant has a variety of physical, emotional, social, and financial concerns, and the assessment will help to determine the extent of his withdrawal from social and familial and community networks and propose treatments.

80The respondent argues that the assessment is not warranted because it is duplicative of a previous psychological assessment. The respondent relies on the IE of Dr. Rakesh Ratti, psychologist, who opined that the treatment plan was not reasonable and necessary because he had already partially approved a treatment plan for a psychological assessment and treatment, and any treatment arising from the biopsychosocial assessment would be redundant with the previous treatment plan.

81As the applicant has not directed me to any evidence in support of the treatment plan or made submissions to rebut the respondent’s submissions, I find that the applicant has not met his onus to prove that the treatment plan is reasonable and necessary.

82Accordingly, the applicant is not entitled to $2,000.00 for a biopsychosocial assessment submitted on December 21, 2022.

Interest

83Interest applies on the payment of any overdue benefits pursuant to s. 51 of the Schedule. As no payments are owing, no interest is due.

Award

84The applicant sought an award under s. 10 of Reg. 664. Under s. 10, the Tribunal may grant an award of up to 50 per cent of the total benefits payable if it finds that an insurer unreasonably withheld or delayed the payment of benefits. The Tribunal has held that an award is justified where the delay or withholding of benefits by the insurer is unreasonable conduct, meaning “behaviour which is excessive, imprudent, stubborn, inflexible, unyielding or immoderate.” The onus is on the applicant to prove, on a balance of probabilities, that the respondent’s conduct meets these criteria.

85The applicant submits that the respondent’s denials served to unreasonably delay his treatment. The applicant did not provide the particulars of the award, and has not provided evidence to establish that the conduct of the respondent rises to the level of unreasonable as set out above.

86As such, I find that the applicant has not met his onus to prove on a balance of probabilities that he is entitled to an award.

87Accordingly, the applicant is not entitled to an award.

ORDER

88I find that:

1. The applicant is not entitled to the treatment plans in dispute.
2. As no payments are owing, no interest is due.
3. The application is dismissed.