Case Study: Joaquim v. Intact Insurance Co.1
The Ontario Superior Court of Justice Divisional Court reviewed a decision of the Licence Appeal Tribunal (the "LAT") and addresses whether auto insurers can require an insured to undergo medical examinations to determine eligibility for prescription medication claims.
Factual Background
Ms. Joaquim (the "Insured") was injured in a motor vehicle accident on January 12, 2017. She filed a claim for statutory accident benefits with her auto insurer, Intact Insurance (the "Insurer"). She then submitted expenses for prescription medication via a standard OCF-6 expenses claim form.
In an effort to determine whether the submitted expenses were reasonable and necessary, the Insurer requested supporting information regarding the prescriptions. The Insured did not respond to this request. Shortly thereafter, the Insurer advised the Insured that she must undergo a section 44(1)2 examination to determine whether the prescription expenses were
