Thomas Elliott

The applicant sought statutory accident benefits for psychological services following a 2016 motor vehicle accident.

The insurer denied the treatment plan based on an insurer's examination which concluded the applicant suffered no accident-related psychiatric impairment.

The Tribunal found that the applicant failed to prove the treatment was reasonable and necessary, noting that the applicant's expert reports related to a previous 2012 accident, there was a lack of psychological complaints to his family doctor, and the applicant successfully completed a realtor program despite alleged concentration issues.

The application was dismissed.

The insurer raised a preliminary issue arguing that the insured was barred from proceeding to mediation and arbitration because he failed to attend a scheduled insurer's examination under section 44 of the Statutory Accident Benefits Schedule.

The arbitrator found that the examination had been cancelled by mutual consent because the insured had travelled to China, and the insurer made no subsequent attempts to reschedule it.

As there was no active examination for the insured to attend, he did not fail to comply with the Notice of Examination.

The insurer's motion was dismissed, and the insured was permitted to proceed to arbitration.