MCI Medical Clinics Inc. - Pre-approved Framework Guideline


MCI Medical Assessments Home Page Why Choose MCI Medical Assessments? Our Services Make a Referral Contact Us Clinic Locations (PDF Map)	Referral for an examination to assist with a determination as to whether an insured person has an impairment to which a Pre-approved Framework Guideline applies. Are you requesting: Paper Review or In Person Examination Section 42 of the SABS provides for only a “Paper Review” in order to assist with the determination as to whether an insured person has an impairment to which a Pre-approved Framework Guideline applies, unless the person(s) conducting the examination determines otherwise. However, subsection 42(7) states that this determination must be made, and that the insured person must be so notified within two business days after the original notice (as described in subsection 42(4)) is given. MCI Medical Assessments understands the problems raised by these statutory requirements. We have put in place the means to allow an Insurer to meet its objective of having an “in person” assessment conducted, while remaining compliant with the SABS and avoiding a violation of the regulation pertaining to “unfair and deceptive practices.” (see s. 5, para. 5, O. Reg. 7/00). In the event that the insurer prefers an in person examination, MCI will arrange for a telephone consultation between the insurer’s representative and the person who is to conduct the examination. The purposes of this consultation will be to discuss the advisability of changing the examination, from the statutorily mandated “paper review,” into an in person examination of the insured person.

Referral for an examination to assist with a determination as to whether an insured person has an impairment to which a Pre-approved Framework Guideline applies.

Are you requesting:

Paper Review

or

In Person Examination

Section 42 of the SABS provides for only a “Paper Review” in order to assist with the determination as to whether an insured person has an impairment to which a Pre-approved Framework Guideline applies, unless the person(s) conducting the examination determines otherwise. However, subsection 42(7) states that this determination must be made, and that the insured person must be so notified within two business days after the original notice (as described in subsection 42(4)) is given.

MCI Medical Assessments understands the problems raised by these statutory requirements. We have put in place the means to allow an Insurer to meet its objective of having an “in person” assessment conducted, while remaining compliant with the SABS and avoiding a violation of the regulation pertaining to “unfair and deceptive practices.” (see s. 5, para. 5, O. Reg. 7/00).

In the event that the insurer prefers an in person examination, MCI will arrange for a telephone consultation between the insurer’s representative and the person who is to conduct the examination. The purposes of this consultation will be to discuss the advisability of changing the examination, from the statutorily mandated “paper review,” into an in person examination of the insured person.