The claimant sought entitlement to IRBs. The claimant had failed to attend IEs, and the insurer argued that the claimant could not proceed with the LAT dispute. The claimant argued that the insurer supplied boilerplate statements which failed to give meaningful notice. Vice Chair McGee concluded that the operative part of the court’s holding in Hedley v. Aviva (that mere boilerplate statements do not provide a principled rationale to which an insured can respond, and therefore constitute no reasons at all) was that reasons must provide a principled rationale to which an insured can respond. To the extent that boilerplate language can effectively communicate the basis of the insurer’s decision and provide a principled basis for an insured person to challenge the denial of a benefit or decide whether to attend an IE, that language may be sufficient to meet the requirements for reasons under the Schedule. Vice Chair McGee held that the claimant was barred from commencing a proceeding before this Tribunal because she failed to attend an IE that the insurer properly requested under section 44 of the Schedule. Vice Chair McGee found that the “medical and any other reasons” the insurer cited in the Notice of Examination set out a principled rationale based fairly on the claimant’s file.
