Dr. Dan Sweet

The appellant appealed an Arbitrator's decision dismissing his claim for income replacement benefits following a motor vehicle accident.

The appellant argued the Arbitrator erred in assessing the evidence, admitting surveillance videotapes that post-dated the claim period, and finding that the insured bears the onus of proving ongoing entitlement to benefits after an insurer terminates them.

The Director's Delegate dismissed the appeal, holding that the Arbitrator's credibility findings and reliance on the insurer's medical experts were amply supported by the evidence.

The Delegate further held that the surveillance evidence was properly admitted to assess credibility and that the ultimate burden of proving entitlement to benefits remains on the insured person.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits, medical benefits, and visiting expenses for his parents.

The insurer terminated benefits, arguing the applicant was not substantially disabled.

The arbitrator found the applicant lacked credibility, noting numerous inconsistencies in his medical history, functional abilities, and income reporting, which were further undermined by surveillance evidence showing him working and moving without apparent difficulty.

The arbitrator concluded the applicant did not suffer significant physical or psychological injuries as a result of the accident and dismissed all claims.