Insurer ordered to pay interest and a special award for unreasonably terminating income replacement benefits.
The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) until the insurer terminated them.
Prior to the arbitration hearing, the insurer conceded the issue and paid the IRBs retroactively.
The arbitrator held that interest on the overdue IRBs began to accrue from the date they were initially terminated, as the insurer bears the consequence of a decision not to pay benefits later found owing.
The arbitrator also awarded a special award of $36,280.00, finding the insurer acted unreasonably by ignoring the conclusions of its own medical and vocational assessors, who noted that the alternative job options proposed did not provide the same remuneration as the applicant's pre-accident employment.
The insurer was ordered to pay $25,000.00 in expenses.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesFeb 27, 2020