Interim income replacement benefits awarded where insurer's medical assessment improperly ignored applicant's chronic pain.
The applicant sought interim weekly income replacement benefits (IRBs) and housekeeping benefits following two motor vehicle accidents.
The insurer had terminated benefits based on an insurer's medical examination which concluded the applicant could return to work.
The arbitrator found that the insurer's medical assessment improperly ignored the applicant's pain and relied on flawed heart rate testing to conclude a lack of effort.
Finding that the applicant established a very probable case for ongoing entitlement, the arbitrator ordered the insurer to pay interim IRBs of $400 per week for a 17-week period.
The claim for interim housekeeping benefits was dismissed for lack of evidence.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesAug 26, 2003
