W.E. v Aviva Insurance Company (18-011102)

The claimant sought removal from the MIG and entitlement to various medical benefits. Adjudicator Conway concluded that pursuant to section 38(11)(1), the insurer failed to comply with section 38(8) in its denial, and was barred from applying the MIG to the disputed benefits. While the adjudicator ultimately concluded that the disputed medical benefit was not reasonable and necessary, the insurer was required to pay for amounts incurred by the claimant.