Income replacement benefits reinstated and special award granted where insurer unreasonably relied on flawed medical reports.
The applicant was injured in a motor vehicle accident and claimed ongoing income replacement benefits.
The insurer terminated benefits based on independent medical examinations and a DAC report suggesting the applicant could work.
The arbitrator found the applicant suffered significant cognitive impairments rendering him competitively unemployable, characterizing his post-accident work at his brother's video store as a sheltered workshop.
The arbitrator ordered the reinstatement of income replacement benefits at $340.53 per week and found the insurer liable for a special award for unreasonably withholding benefits by relying on flawed reports that ignored the overwhelming evidence of the applicant's disability.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesApr 1, 2005
