Accident benefits denied where surveillance evidence contradicted disability claims and symptoms stemmed from pre-existing conditions.
The Applicant sought ongoing weekly income benefits and medical/rehabilitation benefits following a rear-end motor vehicle accident.
The Insurer had terminated benefits based on surveillance evidence showing the Applicant performing heavy lifting, which contradicted his presentation during medical assessments.
The Arbitrator found the Applicant lacked credibility and that his ongoing complaints were primarily attributable to pre-existing obesity, severe sleep apnea, and degenerative back changes, rather than the accident.
The Applicant's claims for ongoing benefits and a special award were dismissed.
The Insurer's claim for repayment of benefits was also dismissed, as the Applicant did not materially contribute to the overpayment through error or fraud.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesJun 27, 1997
