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Attending appointments for the insurance companies

By: Brianna Carmichael, Associate Lawyer

When you are being covered by your insurance company for medical benefits or loss of income benefits, you may find that the adjuster at the company keeps asking you to attend appointments with different specialists and doctors. You might ask yourself, “do I really have to go to all these appointments?”

The short answer is yes.

According to the Standard Automobile Policy of New Brunswick, which all car insurance policies in New Brunswick follow, you are must attend medical examinations at the request of the insurance company, as long as the requests are “reasonable”.

The types of appointments they might send you to include visits with specialist doctors (i.e. orthopedic surgeons, neurologists, psychiatrists, physiatrists, among others) who will provide a report on your condition and how the accident affected it, or with other health care professionals like physiotherapists or occupational therapists for a Functional Capacity Evaluation where they test your ability to sit, stand, lift things, and other physical movements.

They may also send someone to meet with your employer or a human resources officer at your work to do a Job Site Analysis, where they figure out the physical demands of the job you had at the time of the accident.

Essentially, because the insurance company is paying for your medical benefits or for income replacement, in exchange, they are allowed to ask for these kinds of examinations. You must be reasonably accommodating in attending these appointments.

Courts have defined “reasonableness” quite broadly. The insurance company is allowed to ask for multiple examinations with multiple different doctors if you have several different symptoms. They are allowed to ask for a reexamination of you by another doctor every couple of years.

However, the insurance company still has to follow medical directions from your family doctor and other medical professionals you’re seeing. It is always a good idea to talk to your doctor before going to any medical exams for the insurance company and get their opinions and recommendations before you go.

DISCLAIMER: The publications on this website are intended to provide information of a general nature and not legal advice. The information contained in this publication is current to the date of the publication and may be subject to change following the publication date.

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