The applicant was injured in a motor vehicle accident and sought statutory accident benefits.
The respondent partially denied a treatment plan for an in-home occupational therapy assessment, specifically denying costs for documentation, provider travel time, and the initial report.
The applicant applied to the Licence Appeal Tribunal to dispute the denial and sought an award for unreasonably withheld benefits.
The Tribunal found the applicant was entitled to the balance of the cost for the initial report documentation, as the detailed 29-page report and Form 1 reasonably required the time claimed.
However, the Tribunal denied the costs for completing the OCF-18 and provider travel time, finding insufficient evidence to support those claims.
The Tribunal also dismissed the claim for an award, finding the respondent had reasonable grounds for its partial approval and did not act unreasonably.