Chronic pain removes claimants from the Minor Injury Guideline cap for statutory accident benefits.
The applicants were injured in a motor vehicle accident and sought statutory accident benefits.
The insurer capped their medical benefits under the Minor Injury Guideline (MIG) and terminated the husband's income replacement benefits (IRB).
The arbitrator found that both applicants developed chronic pain, which is an aberrant physiology not contemplated by the MIG, thus removing them from the $3,500 cap.
However, the claims for specific medical benefits were dismissed for lack of evidence proving they were reasonable and necessary.
The husband was awarded his claimed IRB as his injuries caused a substantial inability to perform his pre-accident employment as a truck driver.
Expenses were awarded to the applicants.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesMar 23, 2016