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T. T. v. Aviva Insurance Canada (17-002535)

  • January 28, 2018

The claimant sought entitlement to a number of medical treatment plans. The insurer denied the treatment and asserted a MIG position. The insurer also tendered surveillance in support of its position, to which the claimant sought to exclude on the basis of bad faith. Adjudicator Avvy Go determined that the surveillance was in contravention of Rule 9.2 and was not served 10 days prior to the hearing. Moreover, a case conference Order stipulated timelines that the insurer was in contravention of without any explanation. Accordingly, the materials were excluded. Additionally, the insurer was ordered to pay costs on the motion to exclude. However, on the substantive merits of the claim, Adjudicator Go determined that the claimant had not tendered compelling evidence to demonstrate that recovery within the MIG was unavailable; as a result, none of the treatment plans were found payable.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, LAT Rules, Minor Injury Guideline
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