As outlined in the Statutory Accident Benefit Schedule, your insurance company has an obligation to pay for medical and rehabilitation benefits that are reasonable and necessary, resulting from injuries sustained in the accident.
While you and your insurer believe in the importance of your recovery, differences of opinion may arise between you, your treatment providers and your insurer as to what treatment is reasonable and necessary. There may also be discrepancies with respect to entitlement and calculation of income replacement benefits.
Your ensurer will hire a battery of doctors to provide independent medical assessments of your injuries. These reviews will be used by the insurance company to determine the treatments and benefits necessary for your recovery, and your ongoing entitlement to them. In some cases, you may not agree with their assessment.
ABC-Accident Benefit Consultants will ensure that your rights are protected by accessing the dispute resolution process provided by the Financial Services Commission of Ontario. If your insurer disputes your entitlement to a benefit, we will represent you in a Financial Services Commission of Ontario mediation and arbitration hearing. We can also help you obtain alternative medical reports to document your injuries and support your claim.
Insurance policies can be difficult to comprehend, and insurance companies prefer to settle claims as quickly and cost-efficiently as possible. When you have a dispute with your insurance company, do not be intimidated or unduly stressed by harsh words and complex documents.
Contact us to ensure you get the benefits you are entitled to.