In what circumstances will a medical opinion be considered as a factor in determining whether a treatment is reasonable and necessary?
Ontario, Canada
The following excerpt is from L.D. v Certas Home and Auto Insurance Company, 2020 CanLII 43088 (ON LAT):
In any event, I find Rattan v. Aviva distinguishable from this matter. In Rattan v. Aviva, there were competing medical opinions on whether certain treatment was reasonable and necessary and the adjudicator weighed the opinions with consideration as to whether 1) the treatment goals are reasonable 2) the goals are being met to a reasonable degree and 3) the overall cost of achieving these goals is reasonable taking into considering both the degree of success and the availability of other treatment. Here, no weighing of competing opinions is required because the respondent led no evidence to the contrary.
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