Income replacement benefits awarded for a limited period; further medical benefits denied as policy limits exhausted.
The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs) and medical benefits from his insurer.
The insurer initially paid some benefits but later terminated them, arguing the applicant suffered only minor injuries and was capable of working.
The arbitrator found that the applicant was entitled to IRBs for a limited period from August 2013 to October 2013, as he had returned to work thereafter and failed to prove a complete inability to engage in employment.
The claims for further medical benefits were dismissed because the insurer had already paid the $50,000 policy limit after conceding the applicant's pre-existing condition removed him from the Minor Injury Guideline.
Interest was awarded on benefits that the insurer had delayed paying.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesOct 12, 2017