A late denial is treated as effective for the gap

REC-HV-0765-8REVIEWEXCEPTIONSHADOW v1.0HV-0765

DEMO KEY ONLYNOT THIRD-PARTY VERIFIEDSigned with a demo key. Trust root self-published. Third-party verification: none.The demo key is not a firm key: a third party cannot rely on it.

What was checked

Rule: A late denial treated as effective for the gap
Instrument: Statutory Accident Benefits Schedule, O. Reg. 34/10, s. 38(8), (11)
Enforcement: reference, routes to review or escalation
Verification status: SECONDARY Consequence from the 11th business dayFIRM Template conditionFIRM Business-day countingCOUNSEL-CONFIRMS Legislation Act roll-forward section
Policy sources

What it rests on

Input	Value	Basis
Treatment plan received by the insurer	2026-02-14	From a document
Insurer's denial	2026-03-08	From a document
File treated the denial as effective	yes	From a document

Deterministic reasoningno model sits here, by design

Received 2026-02-14; due 2026-03-02 (DATE-01).
Denial 2026-03-08 is after the window.
The file records the denial as effective. The question comes from a template written back from a closed file's recorded outcome; see the policy book.

The record's slots

Confidence: From a document
Question: This denial arrived late. Has the file treated it as effective for the gap, and what is the s. 38(11) exposure from day 11? (benefits clerk)
Reviewer: empty
Tier: SHADOW v1.0 May raise a question. Cannot block, bind or stand as authority (SHADOW-01).
Outcome: empty while the file is open
Coverage: 7 documents on file, all extracted

Evidence packFalcon

A one-page PDF a carrier or the Law Society could read, and a JSON file a machine can check. Built only from this record and its sources.

This record is in shadow. The pack says so: it raises a question and cannot stand as authority.