Self-employed contractor denied ongoing accident benefits; insurer's claim for repayment of overpaid benefits dismissed.
The applicant, a self-employed general contractor, was injured in a motor vehicle accident and claimed ongoing weekly income benefits, vocational retraining, and a special award.
The insurer terminated benefits and sought repayment of overpaid amounts.
The arbitrator found that the applicant was not substantially unable to perform his pre-accident work after July 31, 1995, dismissing the claims for ongoing benefits and retraining.
The arbitrator also determined that the applicant's business income should be calculated using a net/net approach, resulting in a minimum benefit rate.
The insurer's claim for repayment was dismissed as the overpayment resulted from a legitimate dispute over calculation methods rather than error or fraud.
The applicant was awarded arbitration expenses.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesAug 16, 1996
