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Applicant v. Wawanesa Mutual Insurance Company (16-001732)

  • November 21, 2017

The claimant sought entitlement to a number of medical treatment plans. The insurer asserted a MIG position. Adjudicator Robert Markovits reviewed the evidence and determined that there was compelling evidence of a pre-existing medical condition preventing recover within the MIG. The treatment plans were considered reasonable and necessary, with a psychological assessment capped at $2,000.00 pursuant to section 25(5)(a). However, an additional $200.00 was also payable for the completion of the OCF-18 pursuant to Superintendent’s Guideline No. 03/14.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, Minor Injury Guideline
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