Dr. Waldenberg

The appellant sought to appeal an arbitrator's preliminary order denying his request for interim legal expenses to fund a rebuttal catastrophic impairment assessment.

The arbitrator had found that while the appellant met the test for interim legal expenses, the $50,000 limit on medical and rehabilitation benefits under section 18 of the 2010 Schedule precluded the award.

The Director's Delegate exercised discretion to accept the appeal, finding that it raised a novel and broadly important issue of whether the statutory benefit maximums apply to interim expense awards under the Insurance Act.

The applicant, who was injured in a motor vehicle accident, sought an interim order requiring the insurer to fund a rebuttal catastrophic impairment assessment.

The insurer had already paid the $50,000 maximum in medical and rehabilitation benefits for non-catastrophic injuries.

The arbitrator found that while the applicant met the criteria for an interim expense award—raising a bona fide issue, demonstrating the expense was reasonable and necessary, and showing financial inability to pay—the request was barred by the statutory limits.

Because the cost of assessments is included in the medical and rehabilitation benefits limit under the Schedule, the arbitrator could not order the insurer to exceed the $50,000 cap.

The motion was dismissed with no order as to expenses.