Applicant v. Aviva Insurance (18-000467)

The claimant sought entitlement to a mental health assessment. The insurer had requested the claimant’s attendance at an IE to address. The claimant attended the IE but it did not proceed because the claimant wishes to record the IE. The insurer argued that section 55 barred the claimant from seeking entitlement at the LAT. Adjudicator Kershaw held that the insurer’s IE notice was deficient because it did not provide specific details about the claimant’s condition that formed the basis of the insurer’s decision, and when the claimant sought clarification, the insurer said it was simply asking the claimant to comply with the SABS.