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Hamad v. Travelers Insurance (19-014581)

  • July 19, 2021

A preliminary issue hearing was held to determine whether the claimant was barred from proceeding with her claim for NEBs and medical benefits after failure to submit to an insurer’s examination under section 44 of the SABs. The claimant submitted an OCF3 supporting an entitlement to NEBs but containing no medical evidence. The insurer requested that the claimant attend physiatry and in-home OT assessments to determine her entitlement to benefits. The claimant failed to attend the assessments on numerous occasions. The insurer argued that where the OCF3 supported NEB entitlement but contained limited medical evidence, a request for the claimant to attend a section 44 examination was reasonable. The insurer further submitted that there would be no prejudice to the claimant through attendance at the examinations as she had only been examined once in the 3.5 years after the accident. Vice Chair Boyce agreed with the insurer and concluded that the claimant was statute barred under section 55 of the SABs from proceeding with her claim.

Full decision here

TGP Analysis

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