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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.
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