A British Columbia civil resolution tribunal has issued a significant ruling against the Insurance Corporation of British Columbia, ordering the public auto insurer to restore medical benefits to an injured driver. The tribunal found that ICBC overstepped its legal authority during a medical assessment process, leading to an unjust suspension of crucial rehabilitation support.
Driver Accuses ICBC-Appointed Therapist of Acting as Interrogator
The case centers on Muawia Nawa, who suffered injuries in two separate car accidents in 2021 and 2022. According to tribunal documents, ICBC cut off Nawa's medical benefits last year after he refused to complete a medical assessment with an ICBC-appointed occupational therapist. Nawa claimed the therapist acted more like an ICBC interrogator than a healthcare professional during the evaluation.
Assessment Process Sparks Distress and Objections
In late 2024, Nawa attended an initial assessment where an ergonomic evaluation was completed. However, during a follow-up session several weeks later focused on job matching, the situation deteriorated dramatically. Tribunal adjudicator Micah Carmody noted in his decision that Nawa became "very anxious" and "visibly distressed" when the therapist asked him to confirm details about his employer.
Nawa objected to what he described as excessive questioning about business contacts and operational details that he believed went far beyond what was necessary for a functional job match assessment. "He says it felt like an interrogation of his business affairs for ICBC's benefit," Carmody wrote in the tribunal decision.
ICBC's Legal Arguments Rejected by Tribunal
ICBC argued it was justified in suspending Nawa's medical rehabilitation benefits under the Insurance (Vehicle) Act, claiming Nawa refused to comply with a required medical examination without reasonable excuse. The insurer maintained that asking about an employer's legal name constituted "general questions you would ask" to complete a proper assessment.
However, adjudicator Carmody rejected this position, stating clearly: "I do not agree that knowing an employer's legal name is necessary to understand job demands." The tribunal found that ICBC had requested more personal information than was reasonably required for the assessment purpose.
Key Finding: Healthcare Professionals Should Not Serve Dual Roles
A central argument in Nawa's case was his contention that "a health care professional should not serve as both a caregiver and an interrogator for ICBC." While Carmody noted he preferred the occupational therapist's account that she asked only a single question about the employer, he ultimately sided with Nawa regarding the suspension of benefits.
The tribunal's investigation revealed that a follow-up email sent to the therapist seeking clarification about whether employer business names fell within appropriate assessment questions went unanswered, leaving uncertainty about the boundaries of the questioning.
Retroactive Restoration Ordered
In his ruling, adjudicator Carmody ordered ICBC to restore Nawa's medical benefits eligibility retroactively to January 13, 2025. The decision represents a significant check on insurance company authority and establishes important boundaries for medical assessments conducted by insurer-appointed professionals.
The case highlights ongoing tensions between insurance providers and claimants in British Columbia's no-fault insurance system, particularly regarding the appropriate scope of information gathering during medical evaluations. It also raises questions about the dual roles sometimes expected of healthcare professionals working within insurance assessment frameworks.
This ruling comes amid broader discussions about ICBC's practices, following recent cases involving coverage for alternative treatments and limitations on crash victims' ability to sue under British Columbia's insurance reforms. The tribunal's decision reinforces that while insurers have legitimate assessment needs, they must balance these against claimants' rights to privacy and appropriate medical care.
