S.S. v. Aviva General Insurance (17-001183)

The claimant sought entitlement to two treatment plans. The insurer denied the plans and cited insurer’s examination reports as justification. Adjudicator Christopher Ferguson reviewed the medical reports on both sides and noted contradictions in the claimant’s self-reporting. Additionally, one of the treatment plans sought was not included as evidence. The insurer’s evidence was considered more credible and the claims were deemed not payable.