Category: IE Non-Attendance

The claimant sought entitlement to NEBs, removal from the MIG, and various medical benefits. The insurer argued that the claimant’s failure to attend IEs barred her right to proceed with a hearing. Adjudicator Farlam agreed with the insurer and dismissed the application. The insurer had requested IEs to address the claims, and the claimant did not attend any of the IEs (including rescheduled IEs). The IE notices complied with section 44, and the medical and other reasons for the IEs were provided. The claimant did not have a reasonable explanation for not attending the IEs. Over three years had passed since the IEs had been requested, and the insurer was now prejudiced in its adjusting of the claim even if the claimant were to attend new IEs. The LAT application was dismissed.

The claimant attended IEs addressing her determination of a catastrophic impairment, but refused to allow the IE facility to release the assessment reports, arguing that the insurer’s use of a third party to conduct the assessments violated her privacy rights and Charter rights. Adjudicator Norris held that the claimant’s refusal to allow the IE facility to release its reports to the insurer was tantamount to refusal to participate in the IE process. He stayed the proceeding until the claimant participated in the IE process and permitted the IE reports to be released. He also held that the insurer was permitted to use a third party entity to conduct the IEs, and there was no reason why the disclosure of the claimant’s medical records to the IE facility was unlawful.

The claimant applied to the LAT seeking entitlement to a chronic pain assessment and physiotherapy treatment. The insurer sought a determination that the claimant was barred from proceeding to the LAT on the basis that she failed to attend s. 44 assessments. Adjudicator Grant found that the claimant failed to attend s. 44 assessments on five separate occasions, and there was no evidence to explain the non-compliance. The claimant was barred from proceeding to the LAT pursuant to s. 55 of the SABS.

The claimant sought non-earner benefits, a special award and interest. The insurer raised a preliminary issue to determine whether the claimant was precluded from proceeding with her application as she failed to attend a s.44 IE. The insurer also sought costs of the failed IE attendance. The claimant argued that the insurer did not provide sufficient notice of the IE and the IE was not reasonably necessary given the OCF-3 was provided. In addition, the claimant maintained that the insurer did not provide sufficient explanation for the denial of her non-earner benefit and did not disclose its “medical reasons”. The adjudicator found that the claimant was barred from proceeding with her application for failure to attend the IE without reasonable explanation. The adjudicator indicated that the claimant’s argument that she demonstrated entitlement to non-earner benefits and her entitlement for some or all of the time since the accident was irrelevant to the preliminary issue. The evidence did not support the claimant’s argument that the explanations and notice of the IE were unclear and did not disclose sufficient reasons. The application was dismissed, but no costs were awarded to the insurer.