The applicant sought payment for a mental and behavioural assessment as part of a catastrophic impairment determination following a motor vehicle accident.
The insurer denied the cost, arguing it duplicated a psychological assessment within the same treatment plan.
The Tribunal found the assessment was reasonable and necessary, noting that while both assessments were conducted by the same assessor, they utilized different evaluative frameworks (AMA Guides 4th vs. 6th edition) and addressed distinct criteria for catastrophic impairment.
The applicant was awarded the cost of the assessment plus interest.
