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H.S. v. Aviva Insurance Canada (17-007384)

  • July 31, 2019

The claimant sought removal from the MIG and entitlement to four treatment plans for physical therapy. As a preliminary matter, the insurer sought to admit as evidence two addendum report authored after the production deadline. Adjudicator Harper refused to admit the addendum reports, reasoning that they could have been obtained much earlier, since the records reviewed were in the insurer’s possession for some time. Regarding the claimed benefits, Adjudicator Harper concluded that the claimant suffered a concussion, which fell outside of the MIG. She also concluded that the disputed physical treatment was reasonable and necessary because the claimant had long-lasting injuries and she had not achieved maximal recovery.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, LAT Rules, Minor Injury Guideline
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