Accident benefits denied where applicant failed to prove impairments were caused by the collision.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to caregiver, housekeeping, and medical benefits.
The insurer denied the claims on the basis that the applicant's impairments were not caused by the accident.
The arbitrator found that the applicant failed to disclose pre-existing neck and shoulder complaints to his treating practitioners and assessors, and did not report the accident to his family doctor for several months.
The arbitrator concluded that the applicant's impairments were likely caused by pre-existing pathology and the physical strain of caring for his ailing wife, rather than the accident.
The claims were dismissed, save for a small outstanding balance on a previously approved treatment plan.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesSep 30, 2008
