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Applicant v. Aviva Insurance Canada (17-003575)

  • April 5, 2018

The claimant sought entitlement to a neurological assessment and driving evaluation assessment. The adjudicator dismissed the claim for a neurological assessment on the basis that the claimant did not submit any evidence as to why the proposed assessment was reasonable and necessary. The adjudicator also noted that the claimant did not submit any evidence to refute the findings of the IE neurologist, who concluded that the proposed assessment was not reasonable and necessary. With respect to the driving evaluation, the adjudicator concluded that the proposed assessment was partially payable. The adjudicator concluded that the proposed mental health counselling as part of the driving evaluation was duplicative, and therefore not payable. The adjudicator also concluded that the treatment provider’s mileage was not payable as it is not an expense payable under the Guidelines.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits
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