Insurer entitled to deduct prior accident benefits but ordered to pay special award for unreasonable delay.
The applicant was injured in a motor vehicle accident and received income replacement benefits from the insurer.
The insurer terminated benefits based on an orthopaedic surgeon's report that the applicant's ongoing disability was psychological and caused by a prior accident.
The applicant also received a temporary supplement from another insurer for the prior accident.
The arbitrator held that the insurer was entitled to deduct the temporary supplement from the income replacement benefits, as the applicant's inability to work was partly due to the prior accident.
However, the arbitrator also found that the insurer unreasonably delayed reinstating the income replacement benefits by relying on an orthopaedic surgeon's opinion regarding a psychological disability, and ordered the insurer to pay a special award of $2,060.67.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesFeb 6, 2002
