Applicant denied post-104 week income replacement benefits but awarded certain medical and rehabilitation benefits.
The applicant was injured in a motor vehicle accident when she was struck by a car while crossing a street.
She applied for statutory accident benefits, including post-104 week income replacement benefits and various medical and rehabilitation benefits.
The arbitrator found that the applicant suffered from chronic pain but failed to prove a complete inability to engage in suitable employment, dismissing the claim for income replacement benefits.
The arbitrator granted entitlement to an occupational therapy re-assessment, a portion of physical rehabilitation, and a vocational assessment, finding the insurer's denials improper or the treatments reasonable and necessary.
Claims for further physical rehabilitation and orthotics were dismissed.
The arbitrator awarded interest on overdue payments but declined to order a special award against the insurer.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesJan 4, 2018
