Insurer ordered to reinstate accident benefits; termination based on unqualified nurse's assessment and unreliable medical evidence rejected.
The applicant was injured in a motor vehicle accident and received weekly, childcare, and housekeeping benefits until the insurer terminated them, claiming an overpayment.
The insurer relied on a medical report and a nurse's assessment to conclude the applicant was no longer disabled.
The arbitrator found the nurse was not qualified as an expert and her assessment lacked an objective basis, while the treating orthopaedic surgeon's testimony was contradictory and unreliable.
Relying on the applicant's credible testimony regarding her ongoing physical limitations, the arbitrator ordered the reinstatement of all benefits and dismissed the insurer's claim for repayment.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesApr 27, 1993
