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R.L. v. State Farm Insurance Company (17-000020)

  • June 28, 2017

The insurer brought a preliminary issues motion seeking to preclude the claimant from bringing an application for arbitration disputing the denial of medical benefits. The claimant asserted the requested assessments were unreasonable. Adjudicator Maedel identified the following factors to determine if an IE was requested: (i) The timing of the insurer’s request; (ii) The possible prejudice to both sides; (iii) The number and nature of the previous insurer’s examinations; (iv) The nature of the examination(s) being requested; (v) Whether there are any new issues being raised in the applicant’s claim that require evaluation; and, (vi) Whether there is a reasonable nexus between the examination requested and the applicant’s injuries. The requested IEs were deemed reasonable and therefore, per s. 55 of the SABS the claimant was precluding from bringing an application for arbitration due to non-attendance at an IE.

Full decision here

TGP Analysis

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  • FILED UNDER LAT Rules, IE Non-Attendance
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