Licence Appeal Tribunal Orders TD Insurance to Pay Previously Denied Treatment Benefits Following Dr. Bui's Medical Evidence
Another Victory Against TD Insurance: Tribunal Orders Payment of Previously Denied Treatment Benefits
At Pain Rehabilitation Clinic, we believe injured people deserve access to the treatment they need to recover.
In a recent decision, the Licence Appeal Tribunal (LAT) ruled that TD General Insurance Company must pay for rehabilitation treatment benefits that it had previously denied. The Tribunal found that the injured person’s treatment was both reasonable and necessary and ordered TD Insurance to pay the benefits, along with interest on the overdue amounts.
What Happened?
The injured person was involved in a motor vehicle accident and continued to suffer from persistent neck and back pain years after the collision.
Despite ongoing symptoms, TD Insurance denied payment for three rehabilitation treatment plans that included:
- Chiropractic care
- Physiotherapy
- Massage therapy
- Acupuncture
- Active rehabilitation
The injured person appealed the denial to the Licence Appeal Tribunal.
Why Did the Tribunal Rule in the Patient’s Favour?
After reviewing all of the medical evidence, the Tribunal found that the injured person continued to experience chronic pain that affected daily activities, work, sleep, and overall quality of life.
The Tribunal accepted that:
The pain continued long after the accident.
Medical professionals diagnosed chronic myofascial pain.
Previous treatment provided meaningful pain relief and improved function.
Treatment remained reasonable and necessary, even though recovery was gradual.
Gaps in treatment were largely due to financial difficulties and the COVID-19 pandemic, not because treatment was no longer needed.
The Tribunal’s Decision
Adjudicator Ulana Pahuta ruled that TD Insurance should have approved the treatment plans.
TD Insurance was ordered to:
Pay for all three previously denied treatment plans.
Pay interest on the overdue benefits.
What This Means for Accident Victims
Insurance companies do not always make the final decision.
If your treatment has been denied, you may still have options. Strong medical evidence can make a significant difference when challenging an insurance company’s decision.
At Pain Rehabilitation Clinic, Dr. Bui and our multidisciplinary team work closely with lawyers and licensed paralegals by providing thorough medical assessments, detailed clinical documentation, and evidence-based treatment recommendations to help patients receive the care they need.
If your accident benefits have been denied, contact us to learn how we may be able to help support your case.