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R.W.J. v. Aviva Insurance (17-001866)

  • December 8, 2017

The claimant sought entitlement to a special award. During the course of the medical management of the matter, the claimant required medical marijuana. The insurer requested that the claim be submitted via an OCF-18. However, Adjudicator Brian Norris noted that under section 38 a treatment plan is not needed if the drug is prescribed by a regulated health practitioner, as was the case here. Adjudicator Norris reviewed the correspondence between the claimant and the insurer and determined that although wrong to request a treatment plan, the insurer did not act unreasonably to delay a claim as there was other reasons needed for the treatment plan; namely, to determine the appropriate date of loss being claimed as the claimant was involved in multiple MVAs. As a result, no special award was provided.

Full decision here

TGP Analysis

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  • FILED UNDER Special Award
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