Applicant deemed catastrophically impaired due to accident-related mental disorder; ongoing income replacement and housekeeping benefits awarded.
The applicant was injured in a rear-end motor vehicle collision and sought statutory accident benefits from his insurer.
The insurer terminated income replacement, attendant care, and housekeeping benefits, arguing the applicant was no longer disabled and had not sustained a catastrophic impairment.
The arbitrator found that while the applicant's physical injuries were largely resolved or pre-existing, the accident triggered a mental disorder (Adjustment Disorder/Major Depressive Disorder) that caused a marked impairment in the sphere of adaptation.
Consequently, the applicant was deemed catastrophically impaired.
The arbitrator ordered the insurer to pay ongoing income replacement benefits, finding the applicant met both the eligibility and disability tests.
The arbitrator also awarded ongoing housekeeping benefits at $90 per week and specific attendant care benefits, but dismissed the claims for assessment costs and a special award.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesOct 1, 2015
