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Minor insured required to meet complete inability test for EDB at age sixteen, but only partial inability test for LECB offer.
The appellant, who was twelve years old at the time of a motor vehicle accident, applied for an Educational Disability Benefit (EDB) and a Loss of Earning Capacity Benefit (LECB) under the Bill 164 Schedule.
The Director's Delegate confirmed the arbitrator's decision that when the appellant turned sixteen, no EDB was payable unless she suffered a complete inability to carry on a normal life.
However, the Delegate held that the test for an LECB offer when she turned sixteen was either a partial or complete inability to carry on a normal life, and remitted the matter to arbitration to determine if she met this test.
Insurer's motion to compel medical examinations partially granted; orthopaedic, psychological, and neurological assessments found reasonably necessary.
The insurer brought a motion to compel the applicant to attend several medical examinations, including a multidisciplinary assessment, after terminating his weekly income replacement benefits.
The applicant had refused to attend the insurer's scheduled assessments and instead attended his own.
The arbitrator found that orthopaedic, psychological, and neurological assessments were reasonably necessary for the insurer to assess the ongoing medical condition.
However, the arbitrator declined to order work capacity and functional abilities assessments, finding them not reasonably necessary.
The arbitrator also found it premature to order consequences for the applicant's failure to attend.
