The claimant sought entitlement to a number of medical benefits. In addition to a MIG position, the insurer asserted that the claimant was barred from bringing a claim as notice to claim accident benefits was not provided within seven days (or reasonably thereafter) of the MVA, pursuant to sections 32 and 55. Adjudicator S.F. Mather reviewed the circumstances leading up to the claimant providing an application for accident benefits three months following the MVA and determined that the time it took to bring the claim was not unreasonable. Although the application was incomplete, Adjudicator Mather ruled it was reasonable to obtain the missing information on review of the overall claim. With respect to the medical benefits claimed, Adjudicator Mather ruled that the notice letters did not take a position on the MIG and did not provide medical reasons for the denial. As a result, the insurer was precluded from taking a MIG position, and therefore must pay for the treatment plans claimed. No discussion of whether the treatment was reasonable was needed, since the provisions make it clear an insurer shall pay for treatment it fails to provide notice to, until the notice is cured. Therefore the treatment plans claimed were deemed payable.
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