Financial Services Commission of Ontario
Neutral Citation: 2002 ONFSCDRS 149
FSCO A01-001032
BETWEEN:
MARIA JULIA FERREIRA
Applicant
and
NATIONAL FRONTIER INSURANCE COMPANY
Insurer
DECISION ON A PRELIMINARY ISSUE
Before: Suesan Alves
Heard: By telephone conference call on September 9, 2002.
Appearances: David Levy for Ms. Ferreira J. Claude Blouin for National Frontier Insurance Company
Issues:
National Frontier Insurance Company ("National Frontier"), seeks to have Ms. Ferreira submit to two insurer examinations under section 42 of the Schedule.1 Ms. Ferreira disputes that these examinations are reasonably necessary.
The preliminary issue is:
- Is it reasonably necessary for the Insurer to conduct psychiatric and neuropsychological assessments of Ms. Ferreira pursuant to the provisions of section 42 of the Schedule?
Result:
The proposed psychiatric and neuropsychological assessments are not reasonably necessary for purposes of section 42 of the Schedule.
If the parties are unable to agree on expenses of this hearing, that issue may now be addressed.
EVIDENCE AND ANALYSIS:
Background
Ms. Ferreira was injured in a motor vehicle accident on May 4, 1998. At the time of the motor vehicle accident, Ms. Ferreira was aged 47, and worked at two jobs. By day, she cared for a family of four children aged 5 through 14. She also helped with cleaning and housekeeping duties including laundry, cooking and sweeping. In the evenings, she also worked for three hours cleaning offices and banks.
National Frontier paid Ms. Ferreira income replacement benefits for about two years. In this arbitration, Ms. Ferreira claims entitlement to income replacement benefits on an ongoing basis.
Ms. Ferreira alleges that as a result of the accident, she sustained soft tissue injuries which prevent her from doing her cleaning job. Ms. Ferreira also alleges that as a result of the injuries she sustained in the motor vehicle accident, she developed memory and concentration problems, headaches, dizziness, nausea, drowsiness, has low energy, sleeps excessively, and becomes easily confused. She alleges that these symptoms cause her to be disabled. This latter group of symptoms provides the backdrop to the insurer's request for further psychiatric and neuropsychological evaluations.
Dr. K. Stokes, psychologist, conducted a neuropsychological evaluation of Ms. Ferreira in February and March 2000. Dr. Stokes recommended a further psychiatric assessment to determine whether Ms. Ferreira's level of functioning had improved following psychiatric treatment. She also recommended a further neuropsychological assessment to determine if Ms. Ferreira's cognitive impairments continued to deteriorate.
National Frontier seeks a psychiatric assessment on the basis of Dr. Stokes' report and also on the basis of a report prepared by Dr. M. Mammelak, psychiatrist. Shortly before the pre-hearing