Dr. Paul H. Grant

The applicant was injured in a motor vehicle accident and received statutory accident benefits until the insurer terminated her weekly income replacement benefits.

The insurer relied on a Disability DAC assessment concluding she could perform alternative employment.

The arbitrator found that while the applicant was physically capable of performing the tested jobs, she suffered from a chronic pain condition and psychological impairments caused by the accident.

Relying on earlier DAC reports and psychological assessments, the arbitrator concluded that these psychological limitations rendered her completely unable to engage in any employment for which she was reasonably suited by education, training, or experience.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement, medical, housekeeping, and assessment costs.

The insurer terminated benefits based on an assessment by a general practitioner and a Disability DAC report.

The arbitrator found that the applicant suffered a substantial inability to perform her pre-accident employment as a sewing machine operator for the first 104 weeks, relying on the chronic pain diagnosis of her treating physiatrist and psychologist.

However, the applicant failed to meet the stricter "complete inability" test for post-104 week benefits.

The arbitrator awarded the claimed medical, housekeeping, and assessment expenses.

Furthermore, the arbitrator ordered the insurer to pay a $10,000 special award under s. 282(10) of the Insurance Act, finding that the insurer unreasonably withheld benefits by relying on flawed assessments, ignoring substantial medical evidence, and improperly requesting a supplementary report from a neutral DAC assessor.

The applicant was injured in a motor vehicle accident and sought ongoing weekly income replacement benefits after the insurer terminated them.

The arbitrator found that the applicant, a coffee truck operator who suffered a severe shoulder injury requiring multiple surgeries, remained substantially unable to perform the essential tasks of his employment.

The arbitrator rejected the insurer's surveillance evidence and the report of its medical examiner, finding them unpersuasive.

The applicant was awarded ongoing income replacement benefits at $214.19 per week plus interest, but his claim for a special award was denied.