The claimant submitted a treatment plan for chiropractic treatment on June 6, 2017. The insurer denied the claimant’s treatments, as they deemed her to fall within the MIG. The insurer sent a subsequent letter to the claimant advising her of her required attendance at an insurer examination. The claimant submitted an application to the LAT on September 10, 2020. The insurer raised the preliminary issue that the claimant was statue-barred from proceeding with her claim. The claimant argued that the subsequent letter requesting the claimant attend the insurer examinations did not provide a clear and unequivocal denial of the treatment plan. Vice Chair Lake agreed with the insurer, and held that the claimant was statue-barred from pursuing her claim for the June 6, 2017 treatment plan as she applied to the LAT outside the two year limitation period prescribed by s. 56 of the Schedule. Vice Chair Lake found that the insurer’s initial letter was a clear and unequivocal denial of the treatment plan, used language that was directed to an unsophisticated person, and also outlined the dispute resolution process with two warnings of the two-year limitation period in capitalized and bolded font.
