Insurer ordered to pay ongoing income replacement benefits; objective evidence of shoulder tear refuted symptom magnification claims.
The applicant was injured in a motor vehicle accident and sought ongoing income replacement benefits (IRBs) after the insurer terminated them.
The insurer argued the applicant was unemployed at the time of the accident and exaggerated his symptoms.
The arbitrator found the applicant was employed through a temporary placement agency at the time of the accident and that his pre-accident health issues did not prevent him from working.
Relying on objective medical evidence of a torn shoulder tendon, the arbitrator rejected the insurer's expert opinions that the applicant was magnifying his symptoms.
The arbitrator concluded the applicant was substantially unable to perform the essential tasks of his employment and awarded IRBs up to the date he reported limitations from unrelated health conditions.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesJun 25, 2009
