Licence Appeal Tribunal
Citation: G.R. vs. Aviva General Insurance Company, 2019 ONLAT 18-004375/AABS
Tribunal File Number: 18-004375/AABS
In the matter of an Application pursuant to subsection 280(2) of the Insurance Act, R.S.
minicounsel
G.R. v. Aviva General Insurance Company, 2019 CanLII 94064
Case Summary
The applicant was injured in a rear-end motor vehicle accident and sought medical and attendant care benefits from the respondent insurer. The adjudicator denied the claim for attendant care benefits, finding the applicant failed to incur the expenses. However, the adjudicator granted entitlement to four physiotherapy treatment plans, a psychological treatment plan, a functional impairment assessment, and a chronic pain assessment, finding them reasonable and necessary. The adjudicator also awarded a 20% special award under Regulation 664 regarding the functional impairment assessment, concluding the insurer unreasonably withheld approval by relying on an assessor's unconvincing change of opinion.