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D.S. v. Aviva Insurance Company of Canada (18-006592)

  • June 26, 2020

The insurer sought reconsideration of the Tribunal’s award of medical benefits based on section 38 deficient denials, on the basis that the Tribunal failed to consider whether the benefits were incurred. Adjudicator Grant dismissed the reconsideration request. While he agreed with the insurer that the benefits were not deemed incurred under section 3(8), he also explained that a benefit was only payable if it meets the requirements of the SABS (i.e. payment is owed once incurred, and interest owed once overdue).

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, Incurred Expense, Reconsideration
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