In F.J. v Economical Mutual Insurance Company, the Insurer requested that our client’s entire Accident Benefits application is dismissed, due to our client’s alleged failure to attend medical examinations.
The Adjudicator denied the Insurer’s request because the Insurer had unilaterally scheduled the medical assessments, without considering our client’s availabilities. In reaching this conclusion, the Adjudicator wrote:
“In my view, the [Insurer] had a duty to make reasonable efforts to schedule the examination for a day, time and location that was convenient for the [client]…Based on the evidence before me, I find that the applicant was placed in a situation where he was set to fail despite communicating his needs. This is unreasonable.”
The Application was allowed to proceed on its merits.
Read the full decision on CanLIIF.J. v Economical Mutual Insurance CompanyPast results are not a guarantee of a similar outcome. Every claim turns on its own facts.
