Claims for accident benefits dismissed due to lack of causation and symptom exaggeration.
The applicant sought ongoing income replacement benefits, medical expenses, and a special award following a motor vehicle accident.
The insurer denied the claims, arguing the accident did not cause the applicant's injuries and sought repayment of benefits paid, alleging wilful misrepresentation.
The arbitrator found the applicant's evidence unreliable and accepted expert medical evidence that the applicant exaggerated his symptoms and that the accident did not cause his delayed symptoms.
The claims for benefits and a special award were dismissed.
The insurer's request for repayment was also dismissed, as the applicant's exaggeration did not amount to wilful misrepresentation.
The applicant was awarded half of his arbitration expenses.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesAug 20, 1997