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F.S. v. Unica Insurance Inc. (19-001537)

  • February 12, 2020

The claimant sought various accident benefits, including post-104 IRBs. The insurer denied benefits based upon its MIG position. During the course of the claim, the insurer scheduled numerous IEs to determine the MIG and various benefits in dispute, which the claimant did not attend. Following the case conference, with agreement from claimant’s counsel, the insurer rescheduled two of the IEs; the claimant again did not attend. The claimant alleged he had been evicted from his home. At the time of the preliminary issue hearing, the claimant had failed to attend a total of 9 IEs. Adjudicator Boyce ruled that the claimant could proceed with the disputes regarding the MIG, the cost of a chronic pain assessment OCF-18 and the cost of chiropractic treatments as he attended the related IEs. He was barred from proceeding from the remainder of the claim, including IRBs due to failure to attend the relevant IEs.

Full decision here

TGP Analysis

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  • FILED UNDER IE Non-Attendance
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