• FAIR – supporting auto accident victims through advocacy and education
  • FAIR – supporting auto accident victims through advocacy and education
  • FAIR – supporting auto accident victims through advocacy and education

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The requirement to provide “medical reasons” when denying treatment plans: a ticking time bomb?

For an accident benefits insurer, the denial of a treatment plan used to be such a simple thing. Under O. Reg. 403/96, an insurer merely had to provide a standard form letter to deny a treatment plan and schedule a mandatory insurer’s examination. In an attempt to reduce the costs associated with insurer’s examinations, the Ontario Legislature made insurer’s examinations optional in O. Reg. 34/10 (the “SABS”). In doing this, however, it introduced new procedural hurdles that insurers must overcome in order to properly deny treatment plans.

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