COVID-19 UPDATE  

Neither party submits disputed treatment plans to the LAT - AR and Wawanesa Mutual Insurance Company LAT 17-000149 2018 CanLII 2308

April 10, 2018, Kitchener, Ontario

Posted by: Robert Deutschmann, Personal Injury Lawyer

AR and Wawanesa Mutual Insurance Company LAT 17-000149 2018 CanLII 2308 Date: 2018-01-16

Date of Decision: January 16, 2018
Heard Before: Adjudicator Aggrey Msosa

COST OF ORTHOPAEDIC EXAM: Neither party submits disputed treatment plans to the LAT; adjudicator cannot assess them; rules on medical evidence provided


AR  was involved in a car accident on October 11, 2012, and sought benefits pursuant to the SABs. When Wawnesa denied two treatment and assessment plans for orthopedic assessments AR applied to the LAT for arbitration.

Issues

  1. Is AR entitled to payment for the cost of an orthopaedic examination in the amount of $2,149.73 as set out in a treatment and assessment plan?
  2. Is AR entitled to payment for the cost of an orthopaedic examination the amount of $2,200 as set out in a treatment and assessment plan dated?

Results

  1. AR is not entitled to the proposed treatment plans.

The Schedule provides that an insurer shall pay reasonable fees for an examination or assessment. Neither party included a copy of the treatment plans in dispute. The parties were directed in the case conference report and order to include all evidence in support of their positions in accordance with the timetable as set out in the order.

In the absence of these treatment plans, the adjudicator was unable to determine the objectives and goals, nor the proposed treatment, if listed, of the treatment plans. On the basis of the medical evidence provided the Adjudicator found that the neither treatment plans are reasonable and necessary.

Posted under Accident Benefit News, Automobile Accident Benefits, Car Accidents, LAT Case, LAT Decisions, Personal Injury, Treatment

View All Posts

About Deutschmann Law

Deutschmann Law serves South-Western Ontario with offices in Kitchener-Waterloo, Cambridge, Woodstock, Brantford, Stratford and Ayr. The law practice of Robert Deutschmann focuses almost exclusively in personal injury and disability insurance matters. For more information, please visit www.deutschmannlaw.com or call us toll-free at 1-866-414-4878.

It is important that you review your accident benefit file with one of our experienced personal injury / car accident lawyers to ensure that you obtain access to all your benefits which include, but are limited to, things like physiotherapy, income replacement benefits, vocational retraining and home modifications.

Practice Areas

  1. Car accidents
  2. Motorcycle accidents
  3. Automobile accident benefits
  4. Catastrophic injury
  5. Brain or Head injury
  6. Paraplegia and Quadriplegia
  7. Spinal cord injury
  8. Drunk driving accidents
  9. Concussion syndrome
  10. Post Traumatic Stress Disorder
  11. Business Interruption Insurance
  12. Birth Trauma Injury
  1. Wrongful death
  2. Bicycle accidents
  3. Disability insurance claims
  4. Slip and fall injury
  5. Fractures or broken bone injury
  6. Pedestrian accidents
  7. Chronic pain
  8. Truck accidents
  9. Amputation and disfigurement
  10. Fibromyalgia
  11. Nursing Home Fatality Claims

Personal Injury Blog

Aug 13, 2020
Motorcycles – How Dangerous Are They? Very.
Aug 11, 2020
Jury Trials Post COVID-19 – Is it time to review fair pay for jurors?
Aug 11, 2020
Cycling Safety Must be a Priority
Aug 06, 2020
A New Study Shows the Key to Increasing Bike Use is Street Design and Safety
Aug 04, 2020
Post-Concussion Treatment is Extremely Important in Suicide Prevention
Jul 30, 2020
Being the loved one or care giver of someone with TBI can be very challenging

More Personal Injury Articles » 
Review our services

Connect with us

Facebook Twitter Linkedin Youtube Google