Dr. Martin W. Roscoe

The applicant sought ongoing weekly income benefits and medical and rehabilitation benefits following a motor vehicle accident.

The insurer terminated benefits and sought repayment, alleging the applicant was involved in an insurance fraud scheme and had misrepresented his pre-accident and post-accident employment.

The arbitrator found the applicant entirely unreliable, noting he had pleaded guilty to fraud in relation to false employment confirmation forms.

The arbitrator concluded the applicant sustained only minor soft tissue injuries, was not disabled, and had been actively employed in auto body shops during the benefit period.

The application was dismissed, and the applicant was ordered to repay $27,600 in benefits obtained by fraud, plus interest, and to pay the insurer's $2,000 arbitration assessment.

The applicant was struck by a car and claimed statutory accident benefits.

He sought weekly income benefits under section 12 of the Schedule, claiming he was self-employed as a tailor.

The arbitrator found the applicant failed to prove he was employed or self-employed at the time of the accident, as he had declared no income and admitted to avoiding work.

The applicant alternatively claimed ongoing non-earner benefits under section 13.

Relying on consistent specialist medical evidence that the applicant had recovered and was exaggerating his symptoms, the arbitrator concluded the applicant did not suffer a substantial inability to perform his essential tasks.

The claims for ongoing benefits were dismissed, but the applicant was awarded his arbitration expenses.