Insured entitled to ongoing weekly income benefits and a special award for unreasonable termination.
The applicant was injured in a motor vehicle accident and received weekly income benefits from the insurer for 156 weeks.
The insurer terminated benefits, arguing the applicant did not meet the test for disability under section 12(5)(b) of the Statutory Accident Benefits Schedule.
The arbitrator found that the applicant was continuously prevented from engaging in any suitable employment due to physical and psychological impairments caused by the accident.
The arbitrator also found the insurer acted unreasonably in terminating benefits without sufficient medical evidence or providing vocational retraining, and awarded a special lump sum of $5,000.
Finally, the arbitrator ruled that the insurer is entitled to deduct 100 per cent of collateral benefits received by the applicant.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesOct 16, 1996
