Income replacement benefits denied after 104 weeks due to lack of credibility and failure to seek suitable employment.
The applicant was injured in a motor vehicle accident and received income replacement benefits for 104 weeks.
The insurer terminated benefits on the basis that the applicant did not meet the post-104 week test of suffering a complete inability to engage in any suitable employment.
The arbitrator found that the applicant failed to make a bona fide effort to find suitable alternative employment and intentionally limited his job search.
Furthermore, surveillance evidence and inconsistencies in the applicant's testimony severely undermined his credibility regarding his alleged chronic pain and deterioration.
The arbitrator concluded that the applicant failed to establish a prima facie case of total disability and that the insurer had identified suitable alternative occupations.
The application for ongoing income replacement benefits was dismissed.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesSep 12, 2003
