Insurer ordered to pay ongoing caregiver benefits due to applicant's physical injuries and Somatoform Pain Disorder.
The applicant was injured in a motor vehicle accident and received caregiver benefits from her insurer.
The insurer terminated the benefits after 104 weeks, arguing she no longer met the test of suffering a complete inability to carry on a normal life.
The arbitrator found that the applicant's physical injuries, combined with chronic pain and a diagnosed Somatoform Pain Disorder, continuously prevented her from engaging in substantially all of her pre-accident activities.
The arbitrator ordered the insurer to pay ongoing caregiver benefits but declined to order a special award, finding the insurer's denial was not unreasonable given the complex medical evidence.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesDec 18, 2013
