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S.S.R. v. Unifund Assurance Company (18-004772)

  • January 9, 2020

The insurer sought reconsideration of the Tribunal’s award of NEBs and medical benefits, and that section 55 did not prevent the claimant from disputing entitlement to the medical benefits. Vice Chair Lester granted the reconsideration in relation to NEBs, but only in ordering that NEB entitlement began six months after the accident as opposed to four weeks, since the claim was under a transitional policy. The reconsideration was dismissed in relation to entitlement to benefits because no error in law was identified by the insurer and the findings of fact were permissible based on the evidence before the Tribunal. In terms of IE non-attendance, Vice Chair Lester noted that section 55 would only apply if the IEs in question were in relation to a disputed benefit. The notices of examination did not indicate which medical benefits were being addressed, so the Tribunal could not determine if section 55 applied.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, Non-Earner Benefits, IE Non-Attendance, Reconsideration
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