Special award for unreasonably delaying accident benefits reduced from $150,000 to $50,000 for proportionality.
The insurer appealed an arbitration decision awarding the insured a special award of $150,000 under s. 282(10) of the Insurance Act for unreasonably withholding and delaying attendant care and housekeeping benefits.
The Director's Delegate upheld the finding that a special award was warranted, noting the insurer failed to properly advise the insured of available benefits, improperly reduced attendant care, and delayed catastrophic impairment assessments.
However, the Delegate found the $150,000 quantum was disproportionate and overly reliant on a percentage-based calculation rather than the principles of rationality and proportionality.
The special award was reduced to $50,000.
The insurer's appeal regarding the calculation of credits for previously paid benefits was dismissed.