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M.N. v. Aviva Insurance Canada (18-006097)

  • August 15, 2019

The claimant sought reconsideration of the Tribunal’s refusal to re-open her application for entitlement to certain psychological services. The claimant and the insurer had agreed to resolve entitlement to proposed psychological services that were proposed. The services proposed were to be provided by a psychologist at the Guideline rates. The claimant then incurred the treatment with a psychotherapist, but at the psychologist rates. Vice Chair Shapiro concluded that the Tribunal was correct in refusing to re-open the original application. The nature of the dispute was not whether the claimant was entitled to the proposed services, but rather, whether the claimant incurred services that had been approved by the insurer and the proper rate of payment for the services the claimant incurred.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, Reconsideration
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