Insurer ordered to pay ongoing income replacement benefits and a 50% special award for unreasonably withholding payments.
The applicant, a health care aide, was injured in a motor vehicle accident and received income replacement benefits for 104 weeks.
The insurer terminated benefits, arguing she could perform alternative employment.
The arbitrator found the insurer's vocational assessments relied on erroneous assumptions about the applicant's education and skills.
The arbitrator concluded the applicant suffered a complete inability to engage in suitable employment and awarded ongoing benefits.
Additionally, the arbitrator ordered a special award of 50 per cent of outstanding benefits, finding the insurer unreasonably withheld payments by ignoring credible evidence of the applicant's limitations.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesOct 16, 2002