Attending An Insurer’s Examination (IE) after a Car or Personal Injury Accident In Ontario: The Basics

In Ontario, people injured in car accidents are eligible to receive no-fault accident benefits from their insurance company. These benefits can cover lost income and medical or rehabilitation expenses.

After applying for these benefits, the insurer may require the injured person to attend a medical examination conducted by their chosen medical professional. This examination is intended to evaluate whether the person is still entitled to receive benefits.

According to Section 44 of the Statutory Accident Benefits Schedule, insurers must give at least five business days' notice prior to the examination. This notice should include the medical reasons for the examination, whether attendance is mandatory, as well as the details of the examiner and the time and place of the exam.

Assessing the reasonableness of an insurer's request for an examination can be complicated. Simply referencing a medical document may not be enough justification. Indicating that the examination is to determine if an injury is classified as a "minor injury" might also be inadequate.

The Schedule restricts examinations by insurers to what is deemed "reasonably necessary," taking into account factors such as the timing of the request, any previous examinations, and new medical evidence. Typically, the in-person assessment will include a physical exam, questionnaires, and an interview about the accident, injuries, and any pre-existing health conditions.

If your insurer asks for an examination, consulting a lawyer can help you understand whether the request is reasonable and what your rights are in this situation.