Case Summary: Greenidge v. Allstate Insurance Company

INSURANCE ISSUES

Unlike the situation with litigation independent medical examinations per Rule 5.42, a Section B insurer is entitled to insist that the insured attend an independent medical examination per Section B Special Provision 4, and the examiner is entitled to set the conditions of the examination, including refusal to allow the examination to be video recorded. The insurer is entitled to discontinue Section B benefits if the insured refuses to attend such an IME unless it is video recorded.

Greenidge v. Allstate Insurance Company, 2018 ABQB 266 per Neilsen, J. [4285]

FACTS AND ISSUES:

Allstate Insurance Company ("Allstate") issued an SPF No 1 in relation to a 2012 motor vehicle owned by the plaintiff, Jenine Greenidge (the "Policy"). Greenidge was involved in a motor vehicle accident while operating the motor vehicle on January 2, 3015 (the "Accident") while the Policy was in force.

Following the Accident, Greenidge made a claim to Allstate for Section B benefits alleging that she had suffered soft tissue, whiplash, and TMJ injuries. Allstate made payments to her for both the whiplash and TMJ injuries.

On July 16, 2015, Allstate made arrangements for an IME of Greenidge wherein she would be assessed by a specialist Dr. Grade (occupational medicine) pursuant to Special Provisions 4 and 6(b) of Section B of her auto policy, which provide:

(4) Medical Reports. . . the Insurer has the right and the claimant shall afford to a duly qualified medical practitioner named by the Insurer an opportunity to examine the person of the insured's person when and as often as it reasonably requires while the claim is pending, and also, in the case of the death of the insured person, to make an autopsy subject to the law relating to autopsies.

. . .

(6) WHEN MONEYS PAYABLE

. . .

(b) No person shall bring an action to recover the amount of a claim under this section unless the requirements of provisions (3) and (4) are complied with, nor until the amount of the loss has been ascertained as provided in this section.

Greenidge wanted a videographer present for her IME but Dr. Grade did not accept videographers. Allstate took the position that nothing in the SPF No 1 allowed for a right of insureds to insist on video recording of IMEs under Section B and that if the insured refuses to attend the insurer can discontinue any further Section B benefits. Greenidge told Allstate she would pay for the videographer at her expense or have a different...