Applicant ordered to repay $14,086.40 in overpaid accident benefits after failing to prove ongoing disability or claimed income.
The applicant was injured in a motor vehicle accident and received weekly income benefits from the insurer until the insurer stopped payments, alleging an overpayment.
The applicant sought arbitration to reinstate benefits and determine the proper quantum.
The arbitrator found that the applicant suffered only soft tissue injuries and, relying on surveillance evidence and orthopaedic opinion, concluded he was not substantially unable to perform his pre-accident employment.
The arbitrator also found the applicant failed to prove his pre-accident income exceeded the minimum threshold.
Consequently, the arbitrator ordered the applicant to repay $14,086.40 in overpaid benefits, as the overpayment resulted from error or fraud regarding his income.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesNov 21, 1994
