Interim accident benefits granted; insurer's reliance on questionable surveillance video tainted its medical evidence.
The applicant, who was confined to a wheelchair following a motor vehicle accident, sought interim attendant care, caregiving, and housekeeping benefits after the insurer terminated them at the 104-week mark.
The insurer relied on a surveillance video and medical assessments suggesting the applicant was malingering.
The arbitrator found the surveillance video to be of questionable probative value and tainted the insurer's medical evidence.
Applying the prima facie and urgency/necessity tests, the arbitrator granted the interim benefits, noting the extraordinary hardship on the applicant's family who were providing his care.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesMar 1, 2012
