Insured awarded ongoing weekly income benefits and a $5,000 special award for insurer's unreasonable termination.
The applicant was injured in a motor vehicle accident and received statutory accident benefits until the insurer terminated them.
She applied for ongoing weekly income benefits, arguing she suffered from post-concussion syndrome and a brain injury that prevented her from working.
The insurer argued her inability to work was due to pre-existing psychological conditions and post-accident life events.
The arbitrator found that the accident materially contributed to her disability, exacerbating a pre-existing personality disorder, and that she was continuously prevented from engaging in suitable employment.
The arbitrator also ordered a $5,000 special award against the insurer for unreasonably terminating and withholding benefits based on a cursory neurological report while ignoring numerous other medical recommendations.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesJun 24, 1996
