Y.B. v. Aviva Insurance Canada (17-003257)

The claimant sought entitlement to two treatment plans. The insurer denied the plans and asserted neither was reasonable and necessary. The claimant also asserted that the IEs commissioned should have been paper reviews, and therefore not applicable to the insurer’s determination. Adjudicator Christopher Ferguson, on review of the medical evidence, determined that neither treatment plan was reasonable and necessary. The assertion that a paper review IE should have been commissioned, rather than in-person examination, was also rejected.