(1.1) A designated assessment must be conducted by a designated assessment centre that,
(a) is authorized to assess impairments of the type sustained by the insured person; and
(b) is authorized to conduct the type of designated assessment that is required. O. Reg. 313/03, s. 1 (1).
(1.2) A designated assessment must be conducted by a designated assessment centre that is located within,
(a) 30 kilometers of the insured person’s residence, if,
(i) the insured person’s residence is located in the City of Toronto or the regional municipality of Durham
(ii) a designated assessment centre that complies with subsection (1.1) is located within 30 kilometers of the insured person’s residence; or
(b) 50 kilometers of the insured person’s residence, if,
(i) the insured person’s residence is not located in the City of Toronto or the regional municipality of Durham, Halton, Peel or York, and
(ii) a designated assessment centre that complies with subsection (1.1) is located within 50 kilometers of the insured person’s residence. O. Reg. 313/03, s. 1 (1).
(1.3) Subject to subsections (1.1) and (1.2), the insurer and the insured person may jointly select the designated assessment centre if the selection is made not later than the second business day after the insurer or the insured person, as the case may be, receives notice from the other that a designated assessment is required under this Regulation. O. Reg. 313/03, s. 1 (1).
(1.4) If the insurer and the insured person do not jointly select the designated assessment centre in accordance with subsection (1.3), the Superintendent shall, subject to subsections (1.1) and (1.2), select the designated assessment centre. O. Reg. 313/03, s. 1 (1).
(2) If the designated assessment centre is selected by the Superintendent, the designated assessment centre shall, before conducting the designated assessment, give the insurer and the insured person notice disclosing any conflict of interest that the centre has relating to the designated assessment. O. Reg. 313/03, s. 1 (2).
(3) The designated assessment centre shall give any notice required under subsection (2) in respect of a designated assessment described in subsection 43 (11) within three business days after receipt of the request for the designated assessment. O. Reg. 281/03, s. 26.
(4) If a conflict of interest is disclosed under subsection (2),
(a) the designated assessment centre shall conduct the designated assessment if the insurer and the insured person agree; or
(b) if the insurer and the insured person do not agree, the designated assessment shall be conducted, subject to subsections (1.1), (1.2) and (2), by another designated assessment centre selected by the Superintendent. O. Reg. 281/03, s. 26; O. Reg. 313/03, s. 1 (3).
(5) For the purposes of clause (4) (b), the insurer and the insured person shall be deemed not to agree in the case of a designated assessment described in subsection 43 (11) unless they agree by the end of the third business day after the day the insurer receives the notice under subsection (2) or the insured person receives the notice under subsection (2), whichever day is later. O. Reg. 281/03, s. 26.
(6)-(8) Revoked: O. Reg. 313/03, s. 1 (4).
(9) Except as otherwise required under subsection 43 (11), a designated assessment centre must begin a designated assessment within 14 days after receiving a request for the designated assessment. O. Reg. 281/03, s. 26.
(10) If a designated assessment centre is unable to begin a designated assessment within 14 days after receiving the request for the assessment, the insured person or the insurer may require that, subject to subsections (1.1), (1.2) and (2), the designated assessment be conducted by another designated assessment centre selected by the Superintendent. O. Reg. 313/03, s. 1 (5).
(10.1) The Superintendent may, with the consent of the Minister, delegate in writing to any person the Superintendent’s authority to select designated assessment centers under this section. O. Reg. 313/03, s. 1 (5).
(11) For the purpose of this section, a designated assessment centre has a conflict of interest relating to a designated assessment if,
(a) the insurer, the insured person or a lawyer or other representative acting on behalf of the insurer or the insured person has a financial interest in the designated assessment centre; or
(b) the designated assessment centre, a related person, an assessor or consultant who will carry out all or part of the designated assessment or a facility owned or controlled, directly or indirectly, in whole or in part, by the centre or a related person,
(i) Has provided goods or services to the person to be assessed, other than a previous designated assessment,
(ii) prepared or approved a treatment confirmation form under section 37.1, a treatment plan under section 38 or an application for approval of an assessment or examination under section 38.2 for the person to be assessed, or
(iii) is identified by a treatment confirmation form, treatment plan or an application for approval of an assessment or examination as a person who will provide goods or services to the person to be assessed. O. Reg. 281/03, s. 26.
(12) In clause (11) (b),
“Related person” means, in respect of a designated assessment centre, an owner, partner or another person who has a financial interest in the designated assessment centre, but does not include a person who has a financial interest in the designated assessment centre by reason only of being a creditor who deals at arm’s length with the designated assessment centre. O. Reg. 281/03, s. 26.
(1) A designated assessment centre that conducts an assessment under this Regulation of a person who sustains impairment as a result of an accident shall not, after the assessment, provide any goods or services to the person in respect of the accident. O. Reg. 403/96, s. 54 (1).
(2) Subsection (1) does not apply if,
(a) the insured person and the insurer agree; or
(b) there is no other person within 50 kilometers of the insured person’s residence who is able to provide the goods or services. O. Reg. 403/96, s. 54 (2).
(3) Subsection (1) does not prevent the designated assessment centre from conducting another assessment of the person. O. Reg. 403/96, s. 54 (3).
No comments:
Post a Comment