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L.D. v. Aviva Insurance Canada (19-000674)

  • January 10, 2020

The claimant sought entitlement to an orthopedic assessment and interest on the payment of overdue benefits. Adjudicator Boyce found that the disputed orthopedic assessment was reasonable and necessary at the time it was requested because the claimant continued to experience pain post-accident and treatment had plateaued. On this basis, Adjudicator Boyce found it reasonable that a professional assess (or re-assess) her condition to identify the source of her impairments and pain and potentially prevent her pain from becoming chronic (as it apparently became).

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits
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