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Applicant v Aviva General Insurance (17-006243)

  • May 28, 2018

The claimant sought medical benefits for chiropractic services and interest on overdue amounts. Adjudicator Punyarthi held that the treatment plan was neither reasonable nor necessary and that the claimant was not entitled to interest. In support of her claim, the claimant relied on a physician’s report that made a number of treatment recommendations. However, the services on the treatment plan were not listed within the treatment recommendations in the physician’s report. Adjudicator Punyarthi also held that the physician’s report relied on by the claimant contained inconsistent statements regarding the claimant’s prognosis. There was also no affidavit evidence submitted by the claimant on the reasonableness and necessity of the treatment plan.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits
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