Applicant awarded caregiver and attendant care benefits; insurer's malingering allegations rejected despite substance abuse issues.
The applicant was injured in two motor vehicle accidents in 1996 and sought statutory accident benefits for caregiver, housekeeping, and attendant care expenses.
The insurer terminated caregiver benefits and denied attendant care, alleging the applicant was malingering and exaggerating her symptoms, pointing to a pre-existing slip-and-fall injury and substance abuse issues.
The arbitrator found that the applicant sustained psychological and physical injuries in the accidents, leading to disabling psychological and chronic pain conditions.
The arbitrator rejected the insurer's malingering argument, finding the applicant's substance abuse was a misguided effort to control pain.
The applicant was awarded caregiver benefits from February 4, 1997, and attendant care benefits for a limited period, but her claim for additional housekeeping benefits was denied.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesJun 5, 2000
