Dr. Rex Samuel

The insurer brought a motion to compel the insured to attend an independent medical examination by a psychiatrist under section 42 of the Statutory Accident Benefits Schedule.

The insured refused to attend, arguing the examination was for medical-legal purposes rather than determining entitlement to a benefit.

The arbitrator dismissed the motion, finding that arbitrators at the Financial Services Commission of Ontario lack jurisdiction to order an insured to attend a medical examination.

The arbitrator also noted that the insurer's delay in requesting the examination until the eve of the hearing would cause significant prejudice to the insured.

The applicant sought statutory accident benefits for psychological treatment, physiotherapy, housekeeping, and the cost of assessments following a motor vehicle accident.

The arbitrator dismissed all claims, finding that the applicant suffered from significant credibility issues, having failed to disclose a prior accident and pre-existing conditions to medical assessors.

The arbitrator relied on the findings of the insurer's examiners and the Med/Rehab DAC assessors, who concluded that further treatment was not reasonable or necessary.

The claims for housekeeping and assessment costs were also dismissed for lack of evidence and medical referral.

Due to the applicant's lack of success and her representative's problematic conduct during the hearing, the parties were ordered to bear their own arbitration expenses.