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B.H. v. Aviva Canada Inc. (17-003774)

  • September 6, 2018

The claimant sought reconsideration of the Tribunal’s decision that he could not proceed with his application due to failure to attend an IE. Executive Chair Lamoureux held that the insurer’s denial of medication benefits and subsequent request for an IE did not comply with sections 38 and 44 of the SABS. She wrote that the insurer’s denial did not refer to the medical information Aviva relied upon to make its determination or explain why it could not determine whether the treatment recommendations were not reasonable. Executive Chair Lamoureux held that improper denial resulted in the disputed medical benefits being payable.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, IE Non-Attendance, Reconsideration
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