Dr. Z. Marciniak

The applicant sought catastrophic impairment benefits following a motor vehicle accident.

The insurer requested five in-person insurer's examinations.

The applicant agreed to three but refused to attend an in-person physiatry examination and a cardiology examination, arguing they were excessive and unreasonable.

The insurer raised a preliminary issue that the applicant was precluded from proceeding with her application due to her non-compliance.

The Tribunal found that the in-person physiatry examination was not 'reasonably necessary' under section 44 of the Schedule, as it was overly intrusive and the insurer already had sufficient information from other assessments to conduct a paper review.

The applicant was permitted to proceed with her claim.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for treatment plans from a rehabilitation centre.

The insurer denied several treatment plans, relying on physiotherapy utilization guidelines rather than medical opinions, and delayed payments for initial treatments.

The arbitrator found the insurer unreasonably withheld and delayed payments, ordering payment of $1,285 for treatment and a special award of $1,223.63.

However, because the applicant flagrantly refused to comply with a pre-hearing order to produce pre-accident health records, the arbitrator denied the applicant's claim for arbitration expenses.

The applicant was struck by a car and claimed ongoing income replacement benefits and physiotherapy expenses.

The insurer terminated benefits, arguing she could return to her job as a light duty cleaner and sought to deduct alleged post-accident income.

The arbitrator found the applicant suffered a substantial inability to perform the essential tasks of her job due to accident-related knee tendinitis, entitling her to ongoing income replacement benefits.

The arbitrator also found no evidence of actual post-accident income to deduct, and allowed only one month of the claimed physiotherapy expenses, finding the remainder unreasonable.