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Solanes v. Aviva General Insurance (20-001140)

  • May 26, 2021

The claimant sought entitlement to ACBs, and the cost of two assessments. Adjudicator Chakravarti denied entitlement to all claimed benefits. ACBs were stopped at the 104 week mark, so the claimant could not claim ACBs unless she sustained a catastrophic impairment. The claimant failed to provide the Tribunal with the disputed treatment plans, so the Tribunal could not determine whether the assessments were reasonable and necessary. Additionally, the clinical notes and records provided by the claimant did not support the need for an orthopaedic assessment or an in-home assessment.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, Attendant Care Benefits
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