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Chen v. Chubb Insurance Company of Canada (19-008582)

  • December 29, 2020

The claimant disputed her entitlement to NEBs, three medical benefits for treatment, and an attendant care assessment. Adjudicator Grant dismissed all of the claims. He found that the claimant was not prevented from engaging in substantially all of the activities in which she ordinarily had prior to the accident. The claimant had not provided a comparison of her pre- and post-accident activities, specifically on the amount of time spent on said activities, as well as the value and importance placed on each. The adjudicator also noted that the claimant had not provided any affidavits or oral evidence to speak to the Heath v Economical factors, and as such he only had the claimant’s assertions in the written submissions to rely on. Similarly, the claimant’s evidence did not support the need for further treatment, and the IE doctors had concluded that the claimant had reached maximum medical recovery. Finally, the attendant care assessment was not reasonable and necessary because the claimant had reported being independent with self-care.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, Non-Earner Benefits
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