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Terrio v. Aviva General Insurance (20-000524)

  • January 26, 2021

The claimant disputed entitlement to NEBs. The claimant had a number of pre-existing health conditions. The claimant’s affidavit indicated that she was independent prior to the accident, had managed her various medical conditions well, and was looking for employment. Adjudicator Farlam found that the documentary evidence did not prove the claimant’s position. The medical records showed her pre-accident conditions were poorly managed, that she was abusing medications, that she had been unemployed for almost 20 years, and there was no evidence of an ongoing job search. There was also insufficient evidence to establish that the new medical issues reported by the claimant were caused or aggravated by the accident to the extent that the claimant suffered from a complete inability to carry on a normal life. In fact, the claimant’s level of functioning was also found to have improved post-accident, as reported by the claimant to her family physician, noting work as a waitress and riding her bicycle. Surveillance showed the claimant cleaning a motorcycle, socializing with friends, and running errands.

Full decision here

TGP Analysis

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