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I.A. v. Unifund Claims Inc (17-000785)

  • November 9, 2017

The claimant sought entitlement to a number of treatment plans. The insurer asserted a MIG position and also raised a limitation defense to one of the treatment plans. Adjudicator Billeh Hamud reviewed the denial letter of the insurer and found it to be clear and unequivocal. However, Adjudicator Hamud also noted that the claimant established a pre-existing injury that prevented recovery within the MIG; namely chronic pain from a previous MVA. Accordingly, the non-limitation barred treatment plans were found payable.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, Minor Injury Guideline, Limitation Period
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