S.M. v. Aviva General Insurance Company (18-010116)

The claimant sought entitlement to the cost of an accounting report related to IRBs. Adjudicator Boyce dismissed the dispute. He held that it was not reasonable and necessary for the claimant to procure an accounting report. The claimant had a single source of income, and was not self-employed. The existence of short-term disability payments did not justify retaining an accountant. The insurer’s use of an accountant was completed in the scope of properly adjusting the claim, and to address the missing OCF-2 that the claimant’s accountant had not considered.