Insurer's appeal allowed in part; income replacement benefits upheld but special award rescinded due to procedural unfairness.
The insurer appealed an arbitrator's decision awarding the insured income replacement benefits and a $2,500 special award following a minor car wash collision.
The insurer argued the arbitrator erred procedurally by allowing a key medical expert to testify by telephone and substantively by misapprehending the medical evidence regarding the insured's pre-existing conditions.
The Director's Delegate dismissed the appeal regarding income replacement benefits, finding no procedural unfairness and sufficient evidentiary basis for the arbitrator's causation findings.
However, the Director's Delegate rescinded the special award, concluding the arbitrator erred by raising it on his own initiative without providing the insurer adequate notice or opportunity to respond, and by failing to properly assess whether the insurer's withholding of specific medical expenses was unreasonable.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesSep 18, 2000
