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Carter v. Aviva Insurance Company of Canada (19-013446)

  • September 21, 2021

The insurer filed a Notice of Motion seeking to stay the claimant’s application, alleging that the claimant failed to participate in a neuropsychological insurer’s examination meant to assess his entitlement to IRBs. The insurer’s request for a neuropsychological assessment was made after the claimant submitted his own neuropsychological assessment. The insurer corresponded with the claimant’s counsel regarding its request, but no formal IE notice was ever delivered to the claimant. Nevertheless, the insurer argued that the claimant could not proceed with his application until he attended the assessment. Section 55(1) of the Schedule disallows claimants from pursuing his claim for a benefit if he did not attend a properly scheduled and reasonably necessary examination. Section 55(2), however, states that the insurer is required to provide the claimant with notice in accordance with Section 44. Adjudicator Mazerolle concluded that the insurer could not request a stay of proceedings under s. 55(1) because it did not deliver a compliant notice to the claimant. As a result, Adjudicator Mazerolle dismissed the request for a stay.

Full decision here

TGP Analysis

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  • FILED UNDER LAT Rules, IE Non-Attendance
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