Caregiver benefits denied and repayment of $36,295 ordered where applicant misled insurer about income loss.
The applicant applied for caregiver benefits under the Statutory Accident Benefits Schedule, claiming he quit his job to provide full-time care for his son who was injured in a motor vehicle accident.
The insurer had paid some benefits but later sought repayment, arguing the payments were made in error.
The arbitrator found that the son's injuries did not require full-time care beyond normal parental duties and that the applicant had quit his jobs for economic reasons, not to provide care.
The arbitrator dismissed the claim for additional benefits and ordered the applicant to repay $36,295.00 to the insurer, finding that the applicant had misled the insurer about his employment and caregiving status.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesMar 7, 1994
