23 total
Accident benefits claims dismissed due to lack of credibility and surveillance contradicting reported disabilities.
The applicant sought statutory accident benefits for caregiving, housekeeping, and medical expenses following a motor vehicle accident.
The arbitrator dismissed the claims, finding the applicant's evidence regarding his inability to perform housekeeping and caregiving tasks lacked credibility, particularly given his continued full-time employment as a transport truck driver and surveillance evidence showing him performing activities he claimed he could not do.
The arbitrator preferred the insurer's medical expert, concluding the applicant's injuries did not warrant treatment beyond the Pre-Approved Framework.
Arbitrator finds applicant catastrophically impaired, concluding accident trauma exacerbated pre-existing subdural haematoma.
The applicant, an 81-year-old man, was run over by his own vehicle, sustaining orthopaedic injuries.
He subsequently developed significant cognitive impairments.
The insurer denied catastrophic impairment benefits, arguing the cognitive decline was caused by a pre-existing subdural haematoma rather than the accident.
The arbitrator preferred the applicant's medical evidence, finding that the accident likely caused a minor head trauma that, combined with the pre-existing haematoma, resulted in brain edema and catastrophic impairment.
The applicant was awarded ongoing attendant care and housekeeping benefits.
Insured with WAD II and psychological impairment not subject to 16-week cap on income replacement benefits.
The applicant was injured in a motor vehicle accident and diagnosed with a Grade II Whiplash-Associated Disorder (WAD II).
The insurer terminated her income replacement benefits after 16 weeks, relying on section 5(2)(e) of the Statutory Accident Benefits Schedule.
The arbitrator found that the applicant also suffered a psychological impairment resulting from the accident, which excluded her impairment from the Grade II Whiplash Guideline.
Consequently, section 5(2)(e) did not preclude her from receiving income replacement benefits beyond 16 weeks.