Dr. Unarket

The applicant sought payment for a physiatry assessment following a motor vehicle accident that resulted in a traumatic brain injury.

The respondent insurer denied the cost, relying on an assessment by a general practitioner.

The Licence Appeal Tribunal found the physiatry assessment was reasonable and necessary, preferring the evidence of the applicant and her treating professionals.

The Tribunal also found the insurer unreasonably withheld benefits due to multiple errors in handling the file, and ordered a 25% special award under Regulation 664, along with interest on the overdue payment.

The defendant insurer brought a motion for an order requiring the plaintiff to attend a defence medical examination by a new neurologist.

A previous order had granted an examination by a different neurologist, but that expert subsequently refused to provide a report due to workload and complexity.

The plaintiff opposed the motion, arguing it was duplicitous and could jeopardize the upcoming trial date.

The court granted the motion, finding it would be unfair to require the defendant to proceed to trial without defence medical evidence, but imposed strict deadlines for the delivery of the expert report to preserve the trial date.