Dr. Peter Lee

The applicant was injured in a motor vehicle accident and received caregiver benefits for over five years before the insurer terminated them.

She sought a continuation of the caregiver benefit and a non-earner benefit, claiming physical and psychological impairments prevented her from caring for her children and engaging in pre-accident activities.

The Arbitrator found that while the accident materially contributed to her psychological impairments, she exaggerated her physical complaints.

The Arbitrator concluded the applicant did not suffer a complete inability to carry on a normal life, as she was capable of engaging in activities with her children and her condition had improved enough for her supportive counseling file to be closed.

The claims for caregiver benefits, non-earner benefits, and interest were dismissed.

The applicant was injured in a motor vehicle accident and received income replacement benefits for 104 weeks.

The insurer terminated the benefits based on a Designated Assessment Centre (DAC) report concluding the applicant did not suffer a complete inability to engage in any employment for which he was reasonably suited.

The applicant disputed the termination, relying on a failed work trial and expert medical opinions indicating he could not sustain employment due to chronic pain.

The arbitrator rejected the DAC's conclusion, finding its process flawed and its functional abilities testing inadequate to measure the applicant's actual ability to work.

The arbitrator held that the applicant met the test for complete inability to engage in suitable employment and ordered the insurer to pay ongoing income replacement benefits and the expenses of the arbitration.