Applicant awarded 104-week income replacement and partial medical benefits; post-104 week benefits denied.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement and medical benefits.
The arbitrator found that the applicant was substantially disabled from his pre-accident employment as a vacuum installer due to an exacerbation of a pre-existing back condition, entitling him to income replacement benefits for the 104-week period.
However, he did not meet the test for a complete inability to engage in any employment thereafter.
The arbitrator also awarded partial medical benefits, noting the insurer failed to comply with the Schedule's procedures for denying treatment plans, but denied other medical benefits as not reasonable or necessary.
Interest and arbitration expenses were awarded to the applicant.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesDec 13, 2005