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Lin v. Aviva Insurance Canada (19-006064)

  • December 3, 2020

The claimant sought to IRBs and further chiropractic treatment. The insurer raised a preliminary issue that the claimant improperly relied on three exhibits that were not previously served on the insurer and sought to have them struck. Adjudicator Norris agreed holding that the claimant failed to submit evidence to prove that the documents were previously disclosed or to explain the failure to properly disclose them. With respect to IRBs, the insurer paid the benefit until May 27, 2018, when it concluded that the claimant no longer qualified. The adjudicator agreed with the insurer’s decision, stating that the claimant failed to provide evidence that any of her healthcare professionals recommended that she refrain from her pre-accident employment as a supermarket cashier. Finally, the adjudicator found that the treatment plan for chiropractic treatment was not reasonable and necessary because the family physician’s treatment recommendations were untimely and there were no treatment records showing how or if the claimant benefitted from the treatment. The claimant’s family physician made no clear recommendations for the claimant to continue with treatment during the period leading up to and around the submission of the treatment plan.

Full decision here

TGP Analysis

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  • FILED UNDER Income Replacement Benefits, Medical Benefits, LAT Rules
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