Dr. Maureen Baxter

The insurer appealed an arbitration decision that reinstated the claimant's income replacement benefits and ordered a $5,000 special award.

The Director's Delegate allowed the appeal, finding that the arbitrator failed to provide a reasonable explanation for her factual findings, unfairly restricted and ignored the evidence of the insurer's medical expert regarding surveillance video, and failed to adequately address the complexity of the conflicting medical evidence.

The arbitration order was rescinded, the special award was overturned because the insurer reasonably relied on a Designated Assessment Centre report, and a new hearing before a different arbitrator was ordered.

The applicant was injured in a motor vehicle accident while a passenger on a bus.

She received weekly income benefits until they were terminated by the insurer.

The applicant sought reinstatement of weekly income benefits and payment for a secretarial course as a rehabilitation expense.

The arbitrator found that the applicant did not suffer a substantial inability to perform her pre-accident employment immediately following the termination of benefits, but that a subsequent brief return to work exacerbated her condition, entitling her to benefits thereafter.

The claim for the cost of the secretarial course was dismissed as the applicant failed to prove it was a reasonable and suitable rehabilitation expense given her physical limitations.