Insurer Medical Examinations in Ontario: Your Rights, Risks, and How to Protect Yourself

The Section 44 Examination Right

Ontario’s SABS grants insurers the right under section 44 to require claimants to attend medical examinations by healthcare practitioners of the insurer’s choosing. These are used to evaluate the claimant’s condition and frequently generate opinions contradicting those of treating practitioners.

Attendance Is Mandatory — With Limits

Where an insurer properly requests a section 44 examination, attendance is not optional. Refusing without reasonable explanation gives the insurer grounds to suspend benefits. However, the request must satisfy specific procedural requirements: reasonable advance notice; stated purpose; and specified type of health practitioner. Requests failing these requirements can be challenged.

Protecting Your Claim at an IME

Approach any insurer examination prepared: be truthful and precise; describe your worst days, not your best; answer only the question asked without volunteering information; and do not exaggerate or minimize. Your treating physician should be informed of the examination and provided a copy of the resulting report to respond to any inconsistencies.

IMEs in Tort Litigation

In civil personal injury litigation, the Defence may require you to attend medical examinations under Rule 33 of the Rules of Civil Procedure. These are more formal and subject to case management oversight. Attend, be honest, record where permitted, and report any irregularities in the process or resulting report to your lawyer immediately.