The claimant sought entitlement to IRBs, which the insurer denied based on the findings of IEs. By the time of the hearing, IRBs were no longer an issue in dispute, as the insurer later reinstated IRBs and made a lump sum payment representing the amount withheld. The issue of a special award remained. The claimant submitted that the insurer ignored pertinent medical information and relied on flawed IEs for over one year prior to paying the IRBs, and requested a maximum award of 50%. The insurer submitted that it relied on the opinions of its IE assessors, but later re-considered its decision based on updated medical information. Adjudicator Chakravarti found that the insurer acted unreasonably in delaying payment of IRBs, and therefore an award was warranted. Although the insurer’s adjusting was not expected to be perfect, the insurer was expected to consider all of the medical evidence. Adjudicator Chakravarti emphasized that the papering of a termination of IRBs by obtaining a favourable IE report was not a protection against an award when an insurer relies only on that report while closing its mind to the other medical information available. That said, Adjudicator Chakravarti did not agree that the insurer’s unreasonableness rose to the level where the full 50% should be awarded, and found that an award of 35% was warranted.
