Insurer ordered to pay post-104 week income replacement benefits and a $23,000 special award.
The applicant, an emergency nurse, was injured in a motor vehicle accident and sought post-104 week income replacement benefits.
The insurer terminated benefits, arguing she was not substantially disabled.
The arbitrator found that the applicant suffered a complete inability to engage in suitable employment due to her ongoing physical restrictions and the unlikelihood of being hired for sedentary work given her age and disability.
The arbitrator also held that a lump-sum settlement from a collateral carrier could not be deducted from the income replacement benefits.
A special award of $23,000 was granted because the insurer unreasonably withheld benefits by failing to meaningfully adjust the claim after the 104-week mark.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesMar 1, 2012
