Late denial treated as valid: the tribunal disagreed

REC-HV-0901-1REVIEWEXCEPTIONSHADOW v1.0HV-0901

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: Insurer responds to a treatment plan within 10 business days
Instrument: Statutory Accident Benefits Schedule, O. Reg. 34/10, s. 38(8), (11)
Enforcement: reference, routes to review or escalation
Verification status: SECONDARY 10 business days to respondSECONDARY Consequence from the 11th business dayFIRM Business-day countingCOUNSEL-CONFIRMS Legislation Act roll-forward sectionCOUNSEL-CONFIRMS Seeded holiday calendar, 2024 to 2031
Policy sources

What it rests on

Input	Value	Basis
Treatment plan received by the insurer	2026-01-12	From a document
Insurer's denial	2026-02-04	From a document
File treated the denial as effective	yes	From a document

Deterministic reasoningno model sits here, by design

Received 2026-01-12 (Fax confirmation, treatment and assessment plan). Day 1 is the first business day after receipt (DATE-01).
Ten business days: due 2026-01-26.
Denial 2026-02-04 is after 2026-01-26.
Outcome recorded: the s. 38(11) consequence ran from day 11.

The record's slots

Confidence: From a document
Question: none: nothing is missing
Reviewer: empty
Tier: SHADOW v1.0 May raise a question. Cannot block, bind or stand as authority (SHADOW-01).
Outcome: 2026-06-10: A denial issued after the 10-business-day window did not stop the s. 38(11) consequence from the 11th business day.
Coverage: 4 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.