Insurer ordered to pay minor shortfalls in caregiver and housekeeping benefits based on assessment recommendations.
The Applicant was injured in a motor vehicle accident and claimed statutory accident benefits for caregiver and housekeeping expenses.
The Insurer paid portions of the claims but denied others based on in-home assessments and insurer examinations.
The Arbitrator reviewed the medical evidence, including reports from occupational therapists and physiatrists, and found the Applicant was entitled to an additional $310.00 for caregiver benefits and $42.50 for housekeeping expenses for specific periods where the Insurer unreasonably denied or miscalculated the benefits.
Claims for periods after October 2005 were dismissed as the evidence showed the Applicant had regained independence in her activities of daily living.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesJan 31, 2008
