The insurer appealed a ruling in which the claimant was awarded an orthopaedic assessment. The insurer argued that the assessment was available through OHIP, and therefore not payable under the SABS. Executive Chair Lamoureux rejected the reconsideration. She held that the obligation was on the insurer to advance evidence establishing that a benefit at issue was available through a collateral source (such as OHIP), and could not rely upon bare assertions. No evidence was presented about what benefits OHIP covered or the speed at which the claimant could obtain such an assessment through OHIP.
