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R.K.K. v. Cooperators General Insurance Co (19-002834)

  • March 2, 2021

The claimant sought reconsideration of a decision dismissing the claimant’s claim for IRBs and medical benefits. Adjudicator McGhee allowed the reconsideration. Adjudicator McGhee found that the hearing adjudicator’s reasons did not identify key factual findings or demonstrate how the relevant legal tests applied to the facts. The hearing adjudicator failed to explain how he assigned less weight to the evidence of one expert over another, and failing to do so called into question whether the adjudicator was alert and sensitive to the matter before him. Adjudicator McGhee noted that the matter proceeded before the hearing adjudicator in a four-day teleconference hearing and included testimony by the claimant and six expert witnesses. Adjudicator McGhee held that it would be inappropriate and an unnecessary cost and delay to convene a new hearing before a different adjudicator. Instead, Adjudicator McGhee ordered a redetermination on the existing record by the original adjudicator.

Full decision here

TGP Analysis

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  • FILED UNDER Income Replacement Benefits, Reconsideration
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