Dr. James E. Sweeney

The applicant, who was involved in multiple motor vehicle accidents, brought a cross-application for an interim order compelling the insurer to pay past medical and rehabilitation expenses and ongoing treatment and medication costs pending a final arbitration hearing.

The arbitrator dismissed the request for past expenses, finding no urgency and deferring the complex claims to the imminent full hearing.

Regarding ongoing treatment, the arbitrator held that the proposed treatments had not been mediated as required by section 281(2) of the Insurance Act and directed the parties to mediation.

However, the arbitrator ordered the insurer to pay for the applicant's psychiatric and pain management medications pending the final order, as medication had been included in a prior mediation.

The applicant was injured in a motor vehicle accident and received statutory accident benefits until the insurer terminated them.

The applicant sought ongoing weekly income benefits and a special award.

The arbitrator found that the applicant was substantially unable to perform the essential tasks of her pre-accident employment and was continuously prevented from engaging in any suitable employment due to chronic pain and severe depression.

The arbitrator also ordered the insurer to pay a $20,000 special award because it unreasonably withheld benefits by ignoring the recommendations of its own medical experts.