Dr. Alfred Margulies

The applicant was injured in a motor vehicle accident and subsequently developed severe psychological problems, including delusions and paranoia.

He applied for income replacement benefits, which the insurer denied on the basis that his psychological condition was pre-existing and not caused by the accident.

The arbitrator found that the applicant was a 'thin-skulled' individual whose vulnerable defences were overwhelmed by the accident, establishing causation.

The applicant was awarded ongoing income replacement benefits, but his claim for a special award was dismissed as the insurer had not unreasonably delayed or withheld benefits.

The applicant was injured in a rear-end motor vehicle accident and received weekly income benefits for 156 weeks.

The insurer terminated benefits, arguing the applicant's ongoing severe anxiety disorder was not caused by the accident and that he was not continuously prevented from working.

The arbitrator found that the applicant's psychological disability was materially caused by the accident and rendered him unable to maintain employment.

The arbitrator ordered the insurer to pay ongoing weekly income benefits and awarded a $5,000 special award under section 282(10) of the Insurance Act, finding the insurer had unreasonably withheld payments without a reasonable basis.

The applicant was injured in a minor rear-end motor vehicle accident and claimed weekly accident benefits as a homemaker.

The insurer paid benefits until January 3, 1991, and then terminated them based on surveillance and an adjuster's lay observations, despite medical evidence supporting ongoing disability.

The arbitrator found that the applicant's part-time sales work from home did not disqualify her from claiming homemaker benefits under section 13 of the Statutory Accident Benefits Schedule.

The arbitrator concluded that the applicant suffered a somatoform pain disorder triggered by the accident and remained substantially unable to perform her essential homemaking tasks until December 1, 1991.

The arbitrator awarded weekly benefits of $285 for the disputed period and ordered a $4,000 special award against the insurer for unreasonably terminating and withholding benefits without medical evidence.