M. Lee

The applicant sought statutory accident benefits for physiotherapy and various assessments following a motor vehicle accident.

The respondent denied the claims on the basis that the treatments were not reasonable and necessary.

The Tribunal dismissed the application, finding that the applicant failed to meet the burden of proof.

The Tribunal entirely rejected the applicant's occupational therapy expert report, finding the assessor was biased, partisan, and provided opinions outside the scope of their expertise.

As no benefits were payable, the claim for interest was also dismissed.

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.