Dr. James Kirk Houston

The applicant sought income replacement benefits and housekeeping benefits following a motor vehicle accident.

The insurer denied the claims, relying on surveillance evidence showing the applicant working at her family's dry cleaning business and performing physical tasks without apparent difficulty.

The arbitrator found the applicant and her husband lacked credibility, noting numerous contradictions in their testimony.

The arbitrator preferred the medical evidence of the insurer's experts, who concluded the applicant could perform her pre-accident work and housekeeping tasks, over the applicant's experts, who were unaware she had returned to work.

The application for benefits, interest, and a special award was dismissed.

The appellant appealed an arbitration decision denying his claim for weekly income benefits following a motor vehicle accident.

The appellant argued the arbitrator failed to give proper weight to evidence of a flare-up of back problems and a bulging disc.

The Director's Delegate dismissed the appeal, finding that the arbitrator properly weighed the evidence, preferring the uniform opinions of several orthopaedic specialists over the appellant's general practitioner.

The arbitrator's conclusion that the appellant was not substantially unable to perform the essential tasks of his pre-accident work was supported by the evidence.

No appeal expenses were awarded.

The applicant was seriously injured in a motor vehicle accident and received weekly income benefits for 156 weeks.

The insurer terminated the benefits, and the applicant sought ongoing benefits under s. 12(5)(b) of the Statutory Accident Benefits Schedule, arguing she was continuously prevented from engaging in any occupation or employment for which she was reasonably suited.

The arbitrator found that the applicant did not have the physical capacity or stamina to do reasonably suitable full-time work, and that part-time work would not be sufficiently remunerative.

The arbitrator concluded that the insurer acted unreasonably in terminating the benefits given the medical evidence of the applicant's ongoing hip problems and need for further surgery.

The applicant was awarded ongoing weekly income benefits and a special award of $2,000.