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i. My own reading of s.25(1)5 is that it clearly overs CAT assessments. I agree with the reasoning in Henderson that “there is no room for ambiguity – the insurer shall pay the expenses of a CAT assessment”. Other adjudicators have reached the same conclusion.
ii. My reading of s.18(5) is that it plainly refers to assessments in connection with any payment or benefit. I find the term “in connection with” to mean that the section only restricts the consumption of medical benefits by non-CAT impaired persons, and that this narrow restriction excludes assessments not directly related to a specific benefit or benefits.
iii. I concur with a body of decisions that CAT determinations are not a benefit, and neither are assessments required to apply for CAT determination. This further persuades me that CAT assessments are not included in any limit placed on payment for benefits.
iv. I reject the insurer’s proposition that a decision by lawmakers in 2010 to lower the cap for non-CAT medical and rehabilitation benefits from $100,000 to $50,000 should be used to interpret this issue because of a “clear intent to limit recovery”. I find no connection between a decision to lower a cap and any decision as to what things should be included under that cap.
v. The effect of deducting CAT assessment costs from the $50K available to “not-yet-CAT” consumers would be to force seriously injured people to plan to hold a significant percentage of entitlement – in this case 37% — in reserve, just in case they need a CAT assessment. This would represent a serious deterrent to seeking needed treatment, or alternatively act as a major barrier to seeking CAT determination. I find it simply unbelievable that such obvious effects are intended or supported by any reasonable interpretation of the Schedule.