Insurer's suspension of benefits for non-attendance at medical examination ruled unlawful; special award granted.
The applicant was injured in a motor vehicle accident and received statutory accident benefits.
The insurer suspended her benefits after she failed to attend a rescheduled insurer's examination.
The arbitrator found the suspension was unlawful because the insurer applied the wrong version of the Statutory Accident Benefits Schedule and failed to schedule the examination at a convenient time, ignoring her psychologist's advice that she was too emotionally fragile to attend.
The arbitrator awarded caregiver benefits up to the two-year mark, ongoing housekeeping expenses, vehicle modifications to provide automatic transmissions, and various medical and rehabilitation expenses.
A 40% special award was granted against the insurer for unreasonably withholding benefits.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesDec 19, 1997