Self-employed farmer entitled to ongoing weekly income benefits; insurer denied repayment of overpayment caused by its own miscalculation.
The applicant, a self-employed farmer, was injured in a motor vehicle accident and received weekly income benefits from the insurer.
The insurer terminated benefits after 156 weeks, arguing the applicant did not meet the stricter test of disability under section 12(5)(b) of the Statutory Accident Benefits Schedule.
The arbitrator found the applicant was continuously prevented from engaging in suitable employment and remained entitled to benefits.
The arbitrator also accepted the applicant's accountant's calculation of gross weekly income, which treated the value of exchanged family labour as a ceasing business expense.
Finally, the arbitrator held that the insurer was not entitled to repayment of an initial overpayment, as the error resulted from the insurer's interpretation of the legislation rather than any material act or omission by the applicant.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesJun 24, 1997
