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G.S. v. Aviva Insurance Company of Canada (16-001756)

  • May 8, 2017

In this case, the claimant sought entitlement to ACBs and medical benefits. The first Form 1 was submitted by the claimant after the 104 week mark. The insurer argued that it was not liable for payment of any ACBs prior to receipt of the Form 1. Vice Chair Flude accepted the insurer’s arguments and held that section 42 of the SABS required the claimant to submit a Form 1 in a timely fashion, and that failure to do so would relieve the insurer from the obligation to pay for ACBs before it received the Form 1. Vice Chair Flude also dismissed the claims for medical benefits; one on the basis that it was incurred before the treatment plan was submitted to the insurer.

Full decision here

TGP Analysis

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