Applicant awarded ongoing income replacement benefits; insurer's claim for repayment due to overpayment dismissed.
The applicant was injured in a pedestrian knockdown and sought ongoing income replacement and medical benefits.
The insurer terminated benefits, alleging the applicant was exaggerating her symptoms and sought repayment of an overpayment.
The arbitrator found the applicant's presentation of chronic pain and emotional impairments to be genuine, rejecting the insurer's expert who admitted a bias toward skepticism.
The applicant was awarded ongoing income replacement benefits as she was completely unable to engage in suitable employment.
The insurer's claim for repayment was dismissed as the overpayment resulted from an employer error, not the applicant's wilful misrepresentation.
Medical benefits were partially awarded.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesAug 10, 2005
