Weekly benefits limited to minimum amount and terminated early due to surveillance and unreliable financial evidence.
The applicant, a self-employed martial arts instructor, sought statutory accident benefits following a motor vehicle accident.
The insurer terminated weekly benefits in May 1991 and sought repayment of overpaid amounts.
The arbitrator found that based on surveillance evidence and medical reports, the applicant was no longer substantially unable to perform the essential tasks of his occupation after March 11, 1991.
Due to unreliable financial documentation and unexplained discrepancies in the applicant's accounting evidence, the arbitrator awarded only the minimum weekly benefit of $185.60 for the eligible period.
The insurer was ordered to be repaid the overpaid benefits, less the cost of the applicant's treatment.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesApr 22, 1994
