Insurer not bound by single supportive section 44 assessment; full hearing required for catastrophic impairment.
The applicant sought a preliminary order deeming him catastrophically impaired under Criterion 7 of the Statutory Accident Benefits Schedule, relying on a section 44 insurer examination by Dr. Waseem that concluded he met the 55% Whole Person Impairment threshold.
The respondent insurer opposed the motion, relying on conflicting section 44 assessments and an executive summary that concluded the applicant's wheelchair dependency was caused by pre-existing diabetes complications rather than the accident.
The Tribunal dismissed the applicant's request, holding that an insurer is not bound by the opinion of a single section 44 assessor and that a full hearing was required to weigh the complex medical evidence regarding causation.
The Tribunal also ordered the applicant to attend a section 44 psychiatric examination before proceeding with the application.
OLATOntario Licence Appeal TribunalDec 13, 2019