Applicant found catastrophically impaired due to psychological injuries; maximum attendant care and special award granted.
The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.
The insurer denied claims for attendant care, caregiver, and housekeeping benefits, arguing the applicant's injuries were minor and her presentation was not credible.
The arbitrator found that the applicant suffered significant psycho-emotional injuries, including chronic pain syndrome and post-traumatic stress disorder, resulting in a catastrophic impairment.
The arbitrator awarded attendant care benefits at the maximum rate of $6,000 per month, caregiver benefits for her younger son, and housekeeping benefits.
A claim for home modifications was denied as the renovations were planned prior to the accident.
The arbitrator also ordered a 10% special award against the insurer for unreasonably withholding payments without adequately assessing the medical evidence.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesDec 12, 2013
