Accident benefits denied and repayment of $27,600 ordered due to applicant's fraudulent misrepresentations about employment.
The applicant sought ongoing weekly income benefits and medical and rehabilitation benefits following a motor vehicle accident.
The insurer terminated benefits and sought repayment, alleging the applicant was involved in an insurance fraud scheme and had misrepresented his pre-accident and post-accident employment.
The arbitrator found the applicant entirely unreliable, noting he had pleaded guilty to fraud in relation to false employment confirmation forms.
The arbitrator concluded the applicant sustained only minor soft tissue injuries, was not disabled, and had been actively employed in auto body shops during the benefit period.
The application was dismissed, and the applicant was ordered to repay $27,600 in benefits obtained by fraud, plus interest, and to pay the insurer's $2,000 arbitration assessment.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesNov 24, 1998
