Insurer's appeal of a $50,000 special award dismissed; egregious adjusting practices justified the maximum penalty.
The insurer appealed an arbitrator's decision granting a $50,000 special award to the respondent for unreasonably withholding accident benefits following the death of a pedestrian.
The insurer argued the arbitrator erred in law by imposing the award and in calculating its quantum, contending the evidence of an 'accident' was equivocal.
The Director's Delegate dismissed the appeal, finding the special award was justified not by the ultimate evidence, but by the insurer's egregious adjusting practices, including failing to investigate, ignoring evidence, and allowing tort considerations to influence the first-party claim.
The quantum of the award was upheld as rationally related to the misconduct and necessary for deterrence.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesApr 25, 2008
