Applicant v. CAA Insurance (17-001138)

The Tribunal was asked to determine whether the claimant was barred from proceeding with his appeal of the insurer’s denial of medical benefits owing to his failure to attend scheduled examinations, in contravention of section 44.  The claimant had sought a determination of catastrophic impairment. The insurer indicated that further IEs were required to make such a determination, and sent three letters advising the claimant of this. Adjudicator Goela held that the claimant was required to attend the IEs before the matter could proceed to a hearing. Adjudicator Goela noted that the insurer had provided proper notice of the scheduled examinations, and that any prejudice to the claimant could be minimized by rescheduling the examinations promptly.