I.K. v. Primmum Insurance Company (16-001652)

The claimant sought entitlement to a number of medical benefits as well as attendant care benefits. The insurer argued the claimant was barred from proceeding with a LAT application for failing to attend a number of IEs, pursuant to section 55. The LAT agreed and dismissed the matter. On reconsideration, Executive Chair Linda Lamoureux upheld the decision. It was noted that IEs are an important tool for medical management. In this instance, the insurer’s requests were reasonable. The claimant raised an argument that section 55 should operate to bar a proceeding only for the benefits the IE is reviewing and allow all other claims to proceed. Executive Chair Lamoureux noted this argument was new and should have been raised at the Tribunal level and declined to exercise the discretion to hear fresh arguments at the reconsideration level.