Lisa Hanna

Following a finding that the insurer unreasonably withheld income replacement and housekeeping benefits, the arbitrator determined the quantum of a special award under s. 282(10) of the Insurance Act.

The insurer had terminated benefits despite its own assessors concluding the applicant was unable to work and required housekeeping assistance.

The arbitrator fixed the special award at $58,000, representing approximately 20% of the withheld payments inclusive of interest, to punish the insurer's blameworthy conduct and deter future similar actions.

The applicant, a self-employed plumber, was injured in a motor vehicle accident and sought statutory accident benefits.

The insurer terminated income replacement and housekeeping benefits and denied various medical benefits.

The arbitrator found that the applicant suffered a complete inability to engage in suitable employment due to his injuries, which aggravated pre-existing conditions, and awarded ongoing income replacement benefits.

The arbitrator also awarded the claimed medical benefits, housekeeping benefits, the cost of an MRI, and interest at 2% per month.

A special award was granted against the insurer for unreasonably withholding payments, with the amount to be determined.