Insurer ordered to pay ongoing income replacement benefits for chronic pain and depression materially contributed to by accident.
The applicant was injured in a motor vehicle accident and received weekly income replacement benefits until the insurer terminated them.
The applicant applied for arbitration, claiming ongoing benefits due to chronic pain and depression that rendered him unable to perform his pre-accident maintenance job.
The insurer argued the applicant was not disabled and that any impairment was due to pre-existing factors.
The arbitrator found the applicant's pain complaints genuine and supported by medical evidence, concluding he suffered from a chronic pain condition with a significant psychological component.
Applying the thin skull rule, the arbitrator held the accident materially contributed to the disability.
The applicant was awarded ongoing income replacement benefits, interest, and arbitration expenses, as well as partial chiropractic expenses, but the claim for a recliner chair was denied.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesNov 10, 1999