39.1 (1) Subject to subsection 65 (5), an insurer shall mail or deliver a benefit that is payable under this Part to the person entitled within 14 days after the insurer receives an application for the benefit.  O. Reg. 781/94, s. 9. (2) An amount payable under this Part is overdue if the insurer fails to comply with subsection (1).  O. Reg. 781/94, s. 9. (3) If, before payment becomes overdue under subsection (2), the insurer requires that a certificate be furnished under subsection 37 (1) in respect of the benefit, (a)  subsections (1) and (2) do not apply; (b)  the insurer shall mail or deliver the benefit to the person entitled within 14 days after the insurer receives the certificate; and (c)  the amount payable becomes overdue if the insurer fails to comply with clause (b).  O. Reg. 781/94, s. 9. (4) If, before payment becomes overdue under clause (3) (b) in respect of an expense under clause 36 (1) (a), (b) or (c) for services or medication received outside Canada on an elective basis, or an expense under clause 36 (1) (f) for an item for which the Ministry of Health is not paying part of the cost, or an expense under clause 36 (1) (h), the insurer requires that an examination be conducted under section 65, (a)  subsections (1), (2) and (3) do not apply; (b)  the insurer shall, (i)  mail or deliver the payment of the expense to the person entitled within 14 days after the insurer receives the report of the examination under section 65, or (ii)  give the person a notice in accordance with subsection (6) if the insurer refuses to pay the expense; and (c)  the amount payable becomes overdue if the insurer fails to comply with clause (b).  O. Reg. 781/94, s. 9; O. Reg. 26/06, s. 14 (1, 2). (5) When a benefit is paid under this Part, the insurer shall provide the insured person with a written explanation of how the amount of the benefit was determined.  O. Reg. 781/94, s. 9. (6) If the insurer refuses to pay a benefit under this Part, it shall give the insured person notice of the reasons for the refusal within 14 days after the insurer receives the report of the examination under section 65.  O. Reg. 26/06, s. 14 (3). Transitional

39.2 (1) Subsection 36 (4) and sections 39 and 39.1, as they read on February 28, 2006, continue to apply in respect of a claim for payment of an expense under section 36 if, before March 1, 2006, an insurer has given a notice to the insured person under section 39, as it read on February 28, 2006, requiring the insured person to be assessed.  O. Reg. 26/06, s. 15. (2) Despite subsection (1), if an assessment of an insured person by a designated assessment centre cannot be conducted or completed on or after March 1, 2006 because there is no designated assessment centre that satisfies the requirements of this Part, the insurer may give the insured person a notice in writing requiring the insured person to be examined under section 65 in respect of the claim, instead of being assessed by a designated assessment centre, and the provisions of this Regulation, as they read after February 28, 2006, apply in respect of the disposition of the claim after the notice is given.  O. Reg. 26/06, s. 15. PART VIII   REHABILITATION BENEFITS Entitlement to Benefits

40. (1) If an insured person sustains an impairment as a result of an accident, the insurer shall pay for reasonable measures, (a)  to reduce or eliminate the effects of any disability resulting from the impairment; and (b)  to facilitate the insured person’s reintegration into his or her family, the labour market and the rest of society.  O. Reg. 776/93, s. 40 (1). (2) The payments required by subsection (1) for the purpose of facilitating the insured person’s reintegration into the labour market include payment for vocational rehabilitation measures that are reasonably necessary to enable the person to, (a)  engage in an employment that is as similar as possible to employment in which he or she engaged before the accident; or (b)  lead as normal a work life as possible.  O. Reg. 776/93, s. 40 (2). (3) In determining what payments are required under subsection (2), regard shall be had to the insured person’s personal and vocational characteristics.  O. Reg. 776/93, s. 40 (3). (4) The payments required by subsection (1) for the purpose of facilitating the insured person’s reintegration into his or her family and the rest of society include payment for social rehabilitation measures that are reasonably necessary to, (a)  return the insured person as much as possible to the family and social situations in which he or she lived before the accident; (b)  assist the insured person to adjust to family and social situations as a result of the accident; and (c)  maintain the insured person’s level of function within the home and family.  O. Reg. 776/93, s. 40 (4). (5) The payments required under this section include payment of all reasonable expenses incurred by or on behalf of the insured person as a result of the accident for a purpose referred to in clause (1) (a) or (b) for, (a)  social rehabilitation, including life skills training, family counselling, social rehabilitation counselling, financial counselling, home renovations and home devices to accommodate the needs of the insured person, vehicles, vehicle modifications to accommodate the needs of the insured person, and communications aids for the insured person’s home; (b)  vocational rehabilitation, including employment counselling, vocational assessments, vocational training, academic training, workplace modifications and workplace devices to accommodate the needs of the insured person, and communications aids for the insured person’s employment; (c)  services provided by a case manager related to the co-ordination of medical, rehabilitation and attendant care services for the insured person; (d)  transportation for the insured person to and from counselling sessions, training sessions and assessments, including transportation for an aide or attendant; (e)  other goods and services that the insured person requires.  O. Reg. 776/93, s. 40 (5). (6) Transportation expenses under clause (5) (d) in respect of an insured person’s automobile are limited to expenses for fuel, oil, maintenance, tires and parking.  O. Reg. 776/93, s. 40 (6). (7) Subject to subsections (8) and 45 (4), the insurer shall pay an expense under subsection (5) pending resolution of a dispute described in subsection 280 (1) of the Act relating to the expense. O. Reg. 46/16, s. 9. (8) The insurer is not liable to pay an expense under clause (5) (c) pending resolution of a dispute described in subsection 280 (1) of the Act relating to the expense unless the insurer agreed to the appointment of the case manager before the expense was incurred. O. Reg. 46/16, s. 9. Home Modifications

41. (1) If it is more reasonable to purchase a new home to accommodate the needs of an insured person than to renovate the insured person’s existing home, the insurer shall contribute to the cost of a new home in an amount equal to the value of the renovations to the existing home that would have been required to accommodate the needs of the insured person.  O. Reg. 776/93, s. 41 (1). (2) Expenses incurred only for the purpose of giving an insured person access to areas of his or her home that are not needed for ordinary living shall be deemed not to be reasonable expenses for the purposes of this Part.  O. Reg. 776/93, s. 41 (2). Vehicle Modifications