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Applicant v. Aviva General Insurance (19-007805)

  • May 6, 2020

The claimant sought payment of medical benefits and the cost of an assessment, which the insurer agreed to pay by the time of the hearing. The claimant then sought interest on the cost of the assessment. The claimant argued that an OCF-18 for an assessment and invoices were submitted to the insurer on March 28, 2018 via HCAI and was owed interest in the amount of approximately $500.00. The insurer disagreed and submitted that it did not receive the OCF-18 until later in response to its letter to the claimant and the Tribunal that it would pay for the benefits in dispute provided the treatment facility submitted an OCF-18 on HCAI. Adjudicator Flude dismissed the claim for interest on the basis that the claimant failed to provide evidence to satisfy his onus of establishing entitlement to outstanding interest and the insurer had paid the outstanding amount of the invoice within the limits set in the Schedule.

Full decision here

TGP Analysis

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