K.A.J. v. Aviva General Insurance (19-007068)

The claimant sought entitlement to a chronic pain assessment. Adjudicator Goela held that the assessment was not reasonable and necessary, and not payable. Additionally, she held that the treatment plan did not comply with section 38(3) as it was not signed by the claimant or the proposed assessor, nor did assessor provide information or opinion that the assessment was reasonable and necessary. On technical grounds alone, the treatment plan would not have been payable.