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S.B v. Aviva General Insurance Company (19-004142)

  • January 15, 2021

The claimant disputed entitlement to NEBs. The claimant outlined the activities that were important to him before the accident, such as caregiving and spending time with his grandchildren, fishing, hunting with his father and camping. The claimant had a number of pre-existing health issues, but was still able to participate in these activities. As a result of the accident, the claimant experienced additional restrictions that led to inabilities to engage in these activities. Adjudicator Neilson concluded that the claimant was entitled to NEBs. She noted that even though the activities important to the claimant were not strenuous, the claimant was already physically limited before the accident, and as such it did not take much injury from the accident to have a major affect on the claimant’s functional abilities. A special award was not granted, as the adjudicator found the insurer acted reasonably in relying upon the IEs in denying NEBs after six months of payment.

Full decision here

TGP Analysis

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