Applicant ordered to repay over $16,000 in accident benefits after arbitrator finds evidence of malingering and misrepresentation.
The applicant was injured in a motor vehicle accident and received weekly income benefits from the insurer.
The insurer subsequently terminated the benefits and sought repayment, alleging the applicant had misrepresented his pre-accident employment and income.
The arbitrator found the applicant's evidence regarding his employment to be contradictory and unsubstantiated, determining his weekly income benefits should be based solely on his verifiable employment.
The arbitrator also accepted expert evidence that the applicant was malingering and feigning psychological injuries, concluding he was not entitled to ongoing benefits.
The applicant was ordered to repay $16,233.06 in overpaid benefits and $1,000 in arbitration expenses for advancing a frivolous claim.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesAug 16, 1995
