Applicant awarded income replacement and partial medical benefits for soft tissue injuries; special award denied.
The applicant was injured in a motor vehicle accident while riding her bicycle and sought statutory accident benefits.
The insurer terminated her income replacement and medical/rehabilitation benefits based on designated assessment centre (DAC) reports.
The arbitrator found that the applicant suffered a substantial inability to perform the essential tasks of her employment as a house cleaner due to chronic pain, entitling her to income replacement benefits up to the two-year anniversary of the accident.
The arbitrator also awarded medical benefits for prescription medications and transportation expenses, but denied claims for chiropractic care and injections as they were not reasonable or necessary.
The claim for hydrotherapy was deemed premature.
The arbitrator declined to make a special award, finding the insurer's reliance on the DAC reports was not unreasonable.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesDec 16, 1999
