Insurer ordered to pay accident benefits and a $15,000 special award for unreasonably denying claims.
The applicant was injured in a motor vehicle accident and applied for statutory accident benefits, including income replacement and medical benefits.
The insurer denied the claims, arguing the applicant did not have a legitimate contract of employment and was not substantially disabled.
The arbitrator found that the applicant had a valid employment contract as a van driver/delivery person and that his accident-related injuries substantially disabled him from performing the heavy lifting and repetitive movements required for the job.
The arbitrator awarded income replacement benefits, medical benefits, and the cost of a disability certificate.
Furthermore, the arbitrator ordered the insurer to pay a $15,000 special award, finding that the insurer had unreasonably delayed and withheld benefit payments by failing to properly investigate the employment contract and by ignoring procedural notice requirements.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesFeb 9, 2004
