Applicant awarded medical, attendant care, and housekeeping benefits due to insurer's procedural breaches; non-earner benefits denied.
The applicant was injured in a motor vehicle accident and sought various statutory accident benefits, including non-earner, medical, attendant care, and housekeeping benefits.
The insurer suspended benefits after the applicant failed to attend an examination under oath, though a previous arbitrator found the notices defective.
The arbitrator found the applicant entitled to the disputed medical treatment plans, as well as attendant care and housekeeping benefits for a limited period due to the insurer's procedural breach in failing to provide assessment reports in a timely manner.
However, the claim for non-earner benefits was dismissed as the applicant did not meet the test of a complete inability to lead a normal life.
The request for a special award was also denied.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesDec 18, 2019
