Anupama Bakshi

Aviva requested a reconsideration of a Licence Appeal Tribunal decision that awarded D.S. two chiropractic treatment plans and interest.

Aviva argued the Tribunal erred by not addressing whether the benefits were 'incurred' under section 3(7) of the Statutory Accident Benefits Schedule.

The adjudicator dismissed the reconsideration request, finding that a tribunal may order a treatment plan reasonable and necessary, with payment and interest payable only once the expense is actually incurred.

The adjudicator also granted D.S.'s request to amend the original Order to include a third treatment plan that was approved in the reasons but inadvertently omitted from the final Order.

The applicant sought statutory accident benefits for chiropractic and massage therapy following a motor vehicle accident.

The Tribunal found that the insurer failed to provide adequate medical reasons for denying two treatment plans, violating section 38(8) of the Schedule, and ordered them payable.

The Tribunal also found that the applicant suffered from chronic pain and that the remaining chiropractic treatment plans were reasonable and necessary, except for treatment incurred prior to the submission of the plans.

The claim for massage therapy was denied as no treatment plan had been submitted.