Appeal dismissed; a single marked impairment in one area of functioning satisfies the catastrophic impairment definition.
The appellant insurer appealed an arbitrator's decision finding that the respondent pedestrian sustained a catastrophic impairment under clause 2(1.1)(g) of the Statutory Accident Benefits Schedule.
The insurer argued that the arbitrator erred by requiring a marked impairment in only one of four areas of functioning, rather than an overall marked impairment, and by failing to separate physical pain from psychological impairment.
The Director's Delegate dismissed the appeal, holding that the plain language of the Schedule requires only a single marked impairment in one area of functioning.
The Delegate also found no error in the arbitrator's conclusion that the respondent's marked impairment in activities of daily living was due to a mental or behavioural disorder, specifically a pain disorder associated with both psychological factors and a general medical condition.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesDec 22, 2009
