Insurer Examinations (Section 44)
Independent assessment under Ontario's Statutory Accident Benefits Schedule.
Under Section 44 of the SABS, an insurer is entitled to require an insured person to attend an examination to assist the insurer in determining whether the insured is entitled to a benefit under the Schedule. HCMG conducts these examinations across multiple disciplines.
Assessments We Conduct
- •Entitlement to medical and rehabilitation benefits
- •Entitlement to attendant care benefits, including Form 1
- •Entitlement to income replacement and non-earner benefits
- •Treatment plan reviews (OCF-18 disputes)
- •Catastrophic impairment determinations
- •Determinations regarding application of the Minor Injury Guideline
Our Process
01Referral received from insurer with relevant medical documentation
02Examination scheduled with appropriate registered clinician(s)
03Examination conducted (in person or virtually as appropriate)
04Report prepared and issued within agreed turnaround timeframes
05Addendum, supplementary opinion, or testimony available where required
Standards & Conduct
All HCMG assessors comply with the conduct requirements set out in their respective regulatory college standards and with the Licence Appeal Tribunal's expectations regarding independent medical opinion. Reports are prepared in the assessor's own clinical opinion.
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