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Insurer ordered to pay ongoing accident benefits and a special award for unreasonably denying treatment plans.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement, medical, and housekeeping benefits.
The insurer terminated benefits, arguing the applicant's pain responses were exaggerated and his psychological issues stemmed from pre-existing childhood trauma rather than the accident.
The arbitrator found the applicant credible and concluded that the accident was a material contributing factor to his chronic pain syndrome, fibromyalgia, and depression.
The arbitrator awarded ongoing income replacement benefits, medical benefits for various treatments, and housekeeping benefits.
Furthermore, the arbitrator found the insurer acted unreasonably in denying certain treatment plans without a designated assessment, and ordered the insurer to pay a special award under section 282(10) of the Insurance Act.
Accident benefits denied where surveillance video and lack of credibility undermined claims of total disability.
The applicant was injured in a motor vehicle accident and claimed ongoing weekly income benefits and supplementary medical and rehabilitation benefits.
The insurer terminated benefits and sought repayment, arguing the applicant was not disabled and had returned to work at his pizza store.
The arbitrator found the applicant to be an unreliable and evasive witness, relying on surveillance video showing him working.
The medical evidence supporting disability was rejected due to partiality and lack of complete history.
The applicant's claims for ongoing benefits were dismissed, as was the insurer's claim for repayment.
No expenses were awarded to the applicant due to his lack of credibility.
No linked lawyers found.
No linked judges found.
