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E.L. v. Wawanesa Mutual Insurance Company (19-003212)

  • June 15, 2020

The insurer argued that the claimant could not proceed with a LAT hearing because of his failure to attend an IE. The claimant argued that the IE notice was deficient and that the IE request was not reasonable. Adjudicator Punyarthi held that the IE request was reasonable and that the insurer was not required to provide a copy of the contract or retainer between it and the IE facility, or prove which records were given to the IE facility. The request for an IE was also reasonable as the last prior IEs had been performed two years prior and the insurer had to determine whether the MIG still applied to the claimant’s injuries. The adjudicator held that a paper review would not have been sufficient for the insurer at the time the IE was requested, and the insurer would have been prejudiced if a hearing were to proceed. Finally, Adjudicator Punyarthi rejected the claimant’s position that the Tribunal had the authority to reprimand the insurer for a breach of PIPEDA or for an alleged breach of the duty of good faith.

Full decision here

TGP Analysis

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  • FILED UNDER IE Non-Attendance, Jurisdiction
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