Insurance Arbitrator Awards Medical Marijuana

By Roger Foisy on November 21st, 2012

The Financial Services Commission of Ontario has awarded a catastrophically injured motor-vehicle accident victim medical benefits for the purchase of medical marijuana.  The victim’s insurance company is to make payments of $567.60 per month.

In 2000, the applicant suffered a major head injury.  After being awarded and denied various accident benefits, she engaged her insurance company in mediation, which failed, and she then applied to FSCO for arbitration.

The applicant’s claim stated that prescription drugs, opiates, anti-depressants, tranquilizers, and hypnotic medications were ineffective.  The victim claimed that marijuana was the only substance that alleviated her pain, anxiety, insomnia, and poor appetite without significant side effects.

The insurance company argued that medical marijuana was not reasonable or necessary for the applicant, claiming it medically experimental.  The insurer refused to pay for the drug as a form of medical treatment under the Statutory Accident Benefits Schedule.

However, the arbitrator determined that medicinal marijuana is a legitimate treatment method for pain.  The insurance company was unable to prove that the use of marijuana was experimental or that it was ineffective.  While there are controversies and risks to taking marijuana, they do not necessarily make marijuana experimental.  

The applicant’s particular circumstances of pain reduction without serious side-effects suggests that medical marijuana can be a potentially reasonable and necessary treatment for others.

The applicant was not granted complete freedom to decide her own usage.  Her use was monitored for adequate progression in dealing with her pain, while also ensuring that it did not become harmful, or else the benefits could have been lost.  

The arbitrator’s decision in allowing medical marijuana can be viewed as a last resort for treatment because traditional methods proved ineffective.  This decision is not the basis for a cascade of future decisions entitling applicants to medical marijuana use.  It is largely viewed as an expensive last recourse to be justified on an individual basis. 

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