The claimant sought entitlement to two treatment plans for chiropractic services, massage therapy, and physiotherapy. The insurer submitted that it was not liable to pay either treatment plan in dispute because neither were signed by the health care provider and the claimant as required by section 38(3). The claimant argued that the first time the insurer raised the issue of non-compliance with section 38(3) was in its written hearing submissions and the insurer’s denial letters did not raise the issue of the OCF-18s being unsigned. Adjudicator Lake found that if the insurer was not consenting to an unsigned copy of the OCF-18 being received through HCAI and wanted to view the executed hardcopy on file at the clinic, it was incumbent upon the insurer to request a copy of the OCF-18 upon receipt of the electronic version through HCAI. The insurer’s decision to first raise the issue in its written submissions was inappropriate. Adjudicator Lake found that further massage therapy was reasonable, but the remainder of the claims were not proven.
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