You’ve been injured in a car accident, or you’ve made a claim for Long Term Disability Benefits.
Benefits have not yet been paid. The insurance is giving you a tough time. They’re treating you like you’ve done something wrong; when all you’ve done is been in the wrong place at the wrong time resulting in serious injuries. All you want are the benefits you need to help you get better, and make ends meet. After all, isn’t that what insurance is for? Isn’t that why you’ve paid mountains of money in premiums all of these years.
You receive a notice in the mail from your insurer. They want you to attend an IME (Independent Medical Examination) with some doctor or therapist who you’ve never heard of, in a strip plaza or office tower that’s far away from home.
Transportation has been arranged, but the assessment is still going to take up a lot of your time.
You have yet to receive any benefits so why should you bother to attend? You don’t want some strange doctor or therapist touching you, or asking you all sorts of personal questions, and then reporting their findings to strangers at the insurance company. It all seems weird. And who’s paying for these examinations anyway? They aren’t covered by OHIP, and you know that doctors’ time isn’t cheap.
If the request for an IME is as a result of a car accident, unfortunately, the Insurance Act and the Statutory Accident Benefits Schedule (that’s the law dealing with car accident benefit claims) requires that you attend.
Here is an excerpt of the relevant section of the SABS:
Examination Required by Insurer
42. (1) For the purposes of assisting an insurer determine if an insured person is or continues to be entitled to a benefit under this Regulation for which an application is made, an insurer may, as often as is reasonably necessary, require an insured person to be examined under this section by one or more persons chosen by the insurer who are members of a health profession or are social workers or who have knowledge in vocational rehabilitation. O. Reg. 546/05, s. 21.
So, you’ve now read the law which basically requires your attendance at these examinations. Still..what happens if you just don’t go? Read on and we will tell you!
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