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Applicant v. Aviva General Insurance (17-004357)

  • January 31, 2018

The claimant sought entitlement to a psychological assessment, as well as a number of psychological treatment plans. Adjudicator Christopher Ferguson reviewed the denial letter for the psychological assessment, and determined that the Notice failed to provide medical reasons for the denial. Accordingly, by operation of section 38, the assessment was deemed payable. However, based on the medical evidence, it was determined that the psychological treatment was not reasonable. Only interest on the assessment was found payable.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits
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