In Singh and State Farm Mutual Automobile Insurance
Company (FSCO A12-007594), Arbitrator Bayefsky considered
whether the Applicant failed to attend an Examination Under Oath
(EUO) and the consequences of same.
The Applicant was involved in a motor vehicle accident in May
2010. She received income replacement benefits until November
2011 and housekeeping benefits until January 2012. In August
2012, the Insurer advised that they required her to attend an
EUO. While the Applicant attended the EUO, she refused to
answer questions relating to income replacement benefits and
housekeeping benefits on the ground that the Insurer had initially
paid her these benefits and was thereby precluded from requiring
her to attend an EUO.
Pursuant to Section 35(3) of the Statutory Accident
Benefits Schedule, there were three actions that could be taken by
an Insurer upon receiving an Application and a completed Disability
Certificate. They could pay the specified benefit, request an
EUO "or" require the Insured to undergo a medical
examination. The Arbitrator found that this section did not
restrict or diminish the Insurer's general and ongoing option
of requiring an Insured to attend an EUO pursuant to Section
33. Arbitrator Bayefsky found that Section 35(3) did not
preclude an Insurer from requesting an EUO where it initially paid
benefits in response to an Application for Benefits, particularly
where the Insurer subsequently terminated benefits and requested an
EUO. The Arbitrator found that to interpret the provision
otherwise would lead to an absurd result that once an Insurer had
chosen to do one of the three options under Section 35(3), it could
do nothing else in relation to the claim. Accordingly, there
was no reason for the Insurer not to request the EUO. The
Insured was required to attend.
This decision is of assistance to Insurers seeking to examine
Claimants following the termination of benefits. In the past some
Claimant Counsel have refused to permit their client to answer
questions on benefits which have been terminated. This decision
clarifies that such refusals are inappropriate and questions can be
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