The preliminary issue in this matter was whether the insurer’s denials of the disputed treatment plans complied with s. 38(8) of the Schedule. Adjudicator Kaur found that the insurer’s denials of the disputed treatment plans did not comply with s. 38(8) because they did not reference the claimant’s injuries or the medical documentation that was in the insurer’s possession at the time of the denial. Although the insurer did not receive all of the clinical notes and records, a reference could have been made to the documents that were in the insurer’s possession. As a result, the insurer was required to pay for all medical benefits on four treatment plans relating to the period prior to a proper denial was issued. On the merits of the claim, Adjudicator Kaur found that the MIG applied to the claimant’s injuries and that he was not entitled to IRBs.
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