Arbitrator denies income replacement benefits due to insufficient financial disclosure but awards housekeeping expenses.
The applicant was injured in a motor vehicle accident and applied for statutory accident benefits, including income replacement benefits (IRBs) and housekeeping expenses.
The insurer denied the claims.
At arbitration, the central issue was whether the applicant was an employee or self-employed, which dictated the information required to calculate his IRB.
The arbitrator found the applicant was self-employed and had failed to provide the necessary financial information to calculate the benefit, disentitling him to IRBs under section 33 of the SABS-1996.
However, the arbitrator awarded housekeeping expenses based on medical evidence of his impairments and ordered the insurer to pay the applicant's arbitration expenses.
Surveillance evidence obtained deceptively by the insurer was excluded.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesSep 11, 2001
