An insurer medical examination is arranged and paid for by the insurer, and the report goes to the insurer. Attending is usually required, but you are entitled to be accurate rather than agreeable, and the resulting report can be challenged with evidence from those who actually treat you.
What it is for
The stated purpose is an objective assessment. The practical purpose is to obtain a medical opinion the insurer can rely on when deciding whether to fund treatment or continue a benefit.
Some assessors are careful and fair. The structure still means the person examining you was chosen and paid by the party deciding your claim.
How to prepare
Be accurate. Do not exaggerate and do not minimise, which is the more common mistake. People routinely tell an assessor they are managing because that is what they have been telling everyone.
Describe a bad day as well as a good one, and be specific about what you can no longer do rather than describing pain in general terms.
Practical points
Note how long the examination actually lasted. Assessments described as thorough are sometimes very short, and that matters when weighing the report.
Bring a list of your medications and treatment. Ask for a copy of the report, which you are generally entitled to receive.
If the report goes against you
It usually is not the end. A report from an assessor who saw you once carries less weight than consistent evidence from practitioners treating you over months.
That is why continuing treatment and keeping records matters so much.
Questions we get every week
Usually yes. Failing to attend without a good reason can result in a benefit being suspended. If you have concerns, raise them before the appointment rather than skipping it.
Often yes, though the rules vary by assessment type. Ask in advance and get the answer in writing.
Generally yes. You should ask for it, and you should read it.
Where this applies
Accident Benefits
Accident benefits are paid by your own auto insurer regardless of who caused the collision.
Read moreLong-Term Disability
Most long-term disability denials in Ontario are not about whether you are ill.
Read moreInsurance Disputes
Ontario insurers owe policyholders a duty of good faith in how they handle a claim.
Read more