Claims for weekly accident benefits dismissed as applicant failed to prove substantial inability to perform essential tasks.
The applicant was involved in six motor vehicle accidents, two of which (November 1990 and December 1991) were the subject of this arbitration for statutory accident benefits.
The insurer argued the arbitration for the November 1990 accident was time-barred, but the arbitrator found the limitation period did not begin until the insurer provided written notice of refusal with reasons.
On the merits, the arbitrator found the applicant was not entitled to weekly income benefits under section 12 because he had not worked the required 180 days prior to either accident.
Furthermore, the applicant failed to establish a substantial inability to perform his essential tasks as a result of the subject accidents, as his limitations were primarily due to psychological issues stemming from an earlier accident.
The claims for benefits and a special award were dismissed, but the applicant was awarded his arbitration expenses due to the complexity of the case and the insurer's initial acceptance and subsequent denial of the claim.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesJul 6, 1995
