Insurer ordered to pay relocation costs and a $25,000 special award for unreasonably denying mobility accommodation.
The applicant sustained severe mobility impairments following a motor vehicle accident and sought $60,291.10 from her insurer for the costs of moving from her multi-level home to a single-level bungalow.
The insurer denied the claim, arguing that the applicant could still ambulate and later asserting that she failed to submit a formal treatment plan before incurring the expense.
The arbitrator found that the move was a reasonable and necessary accommodation under section 15(5)(i) of the Statutory Accident Benefits Schedule.
The arbitrator also held that the insurer was estopped from relying on the procedural defence regarding the treatment plan due to its conduct.
A special award of $25,000 was granted against the insurer for unreasonably withholding benefits.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesNov 10, 2006
