Accident benefits denied due to pre-existing condition; applicant ordered to repay $20,166.25 in overpaid benefits.
The applicant sought statutory accident benefits following a minor motor vehicle accident.
The insurer terminated weekly income replacement and medical benefits, and sought repayment of an overpayment.
The arbitrator found that the applicant's severe headaches were not caused by the accident, but were related to a pre-existing chronic pain condition.
Furthermore, the applicant was not substantially disabled from performing the essential tasks of her employment as a travel agent.
The arbitrator dismissed the claims for benefits and a special award, and ordered the applicant to repay $20,166.25 in overpaid income replacement benefits because her tax returns showed higher employment income than she had reported to the insurer.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesSep 29, 2000
