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Insurers cannot require section 44 medical examinations to determine eligibility for prescription medication claims.
The appellant was injured in a motor vehicle collision and submitted a claim for prescription medication to her auto insurer.
The insurer required her to undergo a medical examination under section 44 of the Statutory Accident Benefits Schedule to determine if the expense was reasonable and necessary.
When the appellant refused, the Licence Appeal Tribunal barred her from disputing the denial of her claim.
On appeal, the Divisional Court held that the Tribunal erred in its statutory interpretation, finding that insurers cannot require section 44 examinations for prescription medication claims because such claims are not submitted through treatment and assessment plans.
Motion to stay Licence Appeal Tribunal proceeding pending judicial review dismissed for failing RJR-MacDonald test and prematurity.
The applicant insurer brought a motion for an immediate order of prohibition staying a Licence Appeal Tribunal (LAT) proceeding pending judicial review.
The insurer sought judicial review of the LAT's decision to deny its requests to adjourn a written hearing regarding the respondent's entitlement to statutory accident benefits.
The Divisional Court dismissed the motion, finding that the insurer failed to meet the RJR-MacDonald test for a stay, as there was no serious issue to be tried and no irreparable harm.
The court also held that the motion was premature, as it offended the general rule against judicial interference with ongoing administrative processes.
