Dr. M.J. Agapitos

The Applicant was injured in two motor vehicle accidents and claimed statutory accident benefits.

The Insurer terminated her loss of earning capacity benefits and medical benefits, alleging she failed to attend an Insurer Examination.

The Arbitrator found that the Insurer was not entitled to terminate benefits because it had improperly requested a Designated Assessment Centre evaluation without following the required procedures.

The Arbitrator assessed the Applicant's residual earning capacity based on a DAC report and surveillance evidence, finding her capable of part-time self-employment.

The Applicant was awarded ongoing loss of earning capacity benefits, outstanding medical and housekeeping expenses, and a $5,000 special award for the Insurer's unreasonable termination of benefits.

The applicant was injured in a motor vehicle accident while riding his bicycle and subsequently claimed income replacement benefits.

The insurer terminated these benefits based on a Designated Assessment Centre report.

The arbitrator found that the applicant was substantially disabled from performing the essential tasks of his pre-accident employment, which included multiple labour-intensive part-time jobs.

The arbitrator preferred the evidence of the applicant's medical experts over the insurer's assessors.

Furthermore, the arbitrator awarded a $5,000 special award, finding that the insurer acted unreasonably by ignoring additional medical evidence that supported the applicant's claim.

The applicant was injured in a motor vehicle accident and received weekly income benefits from the insurer.

The insurer terminated benefits, arguing the applicant was capable of working and that his disability was caused by his bankruptcy rather than the accident.

The arbitrator found that the applicant suffered from chronic pain syndrome caused by the accident, which continuously prevented him from engaging in any occupation for which he was reasonably suited by education, training, or experience.

The arbitrator also found that the parties had previously settled the quantum of benefits at $600 per week.

The insurer's claim for repayment was dismissed.

A special award of $600 was granted because the insurer unreasonably withheld benefits by failing to provide proper notice of its reasons for termination.