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Applicant v. Aviva Insurance Canada (17-001822)

  • December 11, 2017

The claimant sought entitlement to IRBs and a chronic pain assessment. Adjudicator Hines accepted that the claimant suffered a substantial inability to perform the essential tasks of her pre-accident employment as a sales representative. She preferred the medical opinions of the claimant’s assessors over the insurer’s assessors due to inconsistencies and lack of analysis in the IE reports. The adjudicator was also unswayed by surveillance evidence showing the claimant working at a restaurant, reasoning that the claimant’s pre-accident work was dissimilar enough from the work at the restaurant. The insurer was entitled to deduct any post-accident earnings from the claimant’s IRB. Finally, the claimed chronic pain assessment was awarded as being reasonable and necessary.

Full decision here

TGP Analysis

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  • FILED UNDER Income Replacement Benefits, Medical Benefits
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