Insurer's appeal dismissed; suspension of benefits for refusing excessive medical examinations was unjustified and warranted a special award.
The insurer appealed an arbitration order that reinstated the insured's caregiver benefits and imposed a special award at the maximum rate.
The insurer had suspended benefits after the insured refused to attend two sets of multi-disciplinary medical examinations.
The Director's Delegate dismissed the appeal, upholding the arbitrator's finding that the requested examinations were not reasonably necessary given the extensive medical information already available, including Designated Assessment Centre (DAC) reports supporting the insured's disability.
The Director's Delegate also confirmed the special award, finding that the insurer acted unreasonably in ignoring the medical evidence and the concerns of the insured's treating practitioners regarding the excessive assessments.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesSep 8, 2000
