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Applicant v. Certas Home and Auto Insurance Company (17-006967)

  • July 3, 2018

The claimant sought a determination that her impairments were outside of the MIG as well as entitlement to medical benefits proposed in two treatment plans. Adjudicator Parish found that the claimant was removed from the MIG as a result of the insurer’s failure to comply with the “medical and all other reasons” requirement in s. 38(8) of the SABS. The incurred psychological assessment in dispute was found payable pursuant to s. 38(11) of the SABS. Adjudicator Parish found the proposed psychological treatment to be reasonable and necessary. The claim for a Special Award was denied.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, Minor Injury Guideline
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