Income replacement benefits denied and repayment ordered where self-employed applicant falsified tax returns.
The applicant was injured in a motor vehicle accident and received income replacement benefits from the insurer.
The insurer terminated benefits after 104 weeks and sought repayment, alleging the applicant misrepresented his pre-accident income.
The arbitrator found the applicant was not completely disabled from working as a self-employed renovator, relying on medical evidence including the applicant's own treating surgeon.
The arbitrator also found the applicant lacked credibility and had falsified his tax returns to inflate his business expenses and hide income.
Consequently, the applicant failed to prove the quantum of his income replacement benefit.
The arbitrator ordered the applicant to repay $33,997.72 to the insurer due to wilful misrepresentation and ordered him to pay the insurer's arbitration expenses.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesMar 26, 2003