Insurer's appeal of accident benefits and special award dismissed; termination based on incomplete assessment was unreasonable.
The insurer appealed an arbitration decision awarding the claimant ongoing income replacement benefits, housekeeping benefits, assessment expenses, and a special award under the SABS-1996.
The Director's Delegate dismissed the appeal on the merits, finding no error in the arbitrator's preference for the claimant's medical and lay evidence over the insurer's experts.
The arbitrator's finding that the insurer unreasonably terminated benefits based on an incomplete functional abilities evaluation, justifying a special award, was also upheld.
The appeal was allowed in part only to revoke an inadvertent order regarding arbitration expenses.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesDec 12, 2007
