Kernrechtsfrage
Whether the claimant lost the right to request a formal decision from the accident insurer under Art. 49 and 51 LPGA after its simplified refusal letter of 28 October 2005
Extrahierter Entscheid
The right to request a formal decision expired one year after the insurer's simplified refusal; represented by counsel from May 2006, the claimant could and should have acted within that period.
Extrahierte Begründung
A simplified refusal without proper decision form does not prevent opposition indefinitely. Under the case law on Art. 51 LPGA by analogy, the insured must seek a formal decision within one year, unless a longer period is justified by good-faith reliance on ongoing clarification. That exception did not apply here.