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L.F. v. Aviva General Insurance Company (18-008308)

  • March 3, 2020

The claimant sought reconsideration of the Tribunal’s decision that she was barred from disputing entitlement to medical benefits because she failed to attend an IE assessment. Adjudicator Norris concluded that he did not commit an error in regard to the proper medical and other reasons for the insurer’s denial since the insurer’s letter noted that the proposed services were not consistent with the injuries report, and noted gaps in treatments without any clinical documentation to explain the same. He also found that there was no violation of procedural fairness as the claimant could attend the IE and re-apply to the LAT if the benefits remained denied.

Full decision here

TGP Analysis

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  • FILED UNDER IE Non-Attendance, Reconsideration
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