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A.S. v. Certas Home and Auto Insurance Company (19-004994)

  • August 12, 2020

The claimant was involved in a 2009 accident. She sought entitlement to three assessments and a series of CAT assessments. An initial issue was raised as to whether section 25 of the post-2010 SABS applied, or if section 24 of the earlier SABS applied. The adjudicator held that section 25 of the 2010 SABS applied, as the transitional rules did not keep section 24 in force. On the claimed benefits, Adjudicator Farlam concluded that none of the assessments were payable. the claimant failed to provide evidence that the subject accident caused ongoing impairment, particularly in light of a subsequent accident she was involved in. Regarding the claimed CAT assessments, the adjudicator held that there was no reasonable basis to investigate whether the claimant was catastrophically impaired, and no evidence led that the claimant might have a 55 percent WPI. It was again noted that the claimant’s complaints arose primarily after her second accident.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, CAT Assessments
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