The claimant was involved in an accident. She incurred transportation expenses in relation to her hip replacement surgery, and submitted these expenses to her insurer. The insurer denied payment of the transportation expenses as the records did not support that the surgery was required as a result of the accident. The claimant submitted an additional report from her doctor, and the insurer provided notice that the claimant was to attend an IE. The applicant refused to attend, claiming that the insurer had no right to request an examination under s. 44 as a treatment plan was not required for mileage expenses. Adjudicator Kaur held that the insurer has the right to request an IE in respect of transportation services, as they are medical benefits under s. 15(1)(g) of the SABS, and that the insurer may require the claimant to be examined to determine her entitlement to the medical benefit of transportation expenses. However, the insurer’s notice of examination was found to be defective, as it failed to mention the “medical and any other reasons” which formed the basis for the insurer’s decision.
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