2 total
Insured entitled to ongoing income benefits as proposed sedentary jobs were not reasonably suitable given his military background.
The applicant, a military reservist, was struck by a motor vehicle and received weekly income benefits for 198 weeks.
The insurer terminated benefits, arguing the applicant could return to light sedentary work.
The arbitrator found that while the applicant was physically capable of light sedentary work, he was not 'reasonably suited' for such employment by his education, training, or experience, given his long career in a demanding military role.
The arbitrator also determined the correct quantum of the weekly benefit based on bank records, as official payroll records were unreliable.
The insurer's claim for repayment of prior overpaid benefits was dismissed because the applicant did not contribute to the error.
Insured entitled to ongoing weekly income benefits as injuries prevented her from working required long hours.
The applicant was injured in a motor vehicle accident and received weekly income benefits until the insurer terminated them, arguing she was no longer disabled.
The applicant, a real estate agent, claimed she could not work the long and unpredictable hours required by her occupation due to ongoing neck and back pain.
The arbitrator preferred the medical evidence of the applicant's treating specialist over the insurer's expert, finding that the ability to perform essential tasks must incorporate the ability to perform them in a manner that renders the work remunerative.
The arbitrator concluded the applicant suffered a substantial inability to perform the essential tasks of her occupation and ordered the reinstatement of weekly income benefits.
No co-appearing lawyers found.
No judges found.