The respondent insurer requested a reconsideration of a preliminary decision which found that the applicant's claims for attendant care and medical benefits were not statute-barred.
The original adjudicator had concluded that the insurer's denial notices were not 'clear and unequivocal' because they included an application for catastrophic impairment, which might confuse an unsophisticated person.
On reconsideration, the Associate Chair found that the adjudicator made a significant error of law or fact.
The Associate Chair held that the denial notices, which included standard-form disclosures of the right to appeal and the two-year limitation period, were clear and unequivocal.
Consequently, the reconsideration was granted, and the applicant's claims for the disputed benefits were dismissed as statute-barred.