Dr. Perry Rush

The appellant appealed an Arbitrator's decision dismissing his claim for income replacement benefits following a motor vehicle accident.

The appellant argued the Arbitrator erred in assessing the evidence, admitting surveillance videotapes that post-dated the claim period, and finding that the insured bears the onus of proving ongoing entitlement to benefits after an insurer terminates them.

The Director's Delegate dismissed the appeal, holding that the Arbitrator's credibility findings and reliance on the insurer's medical experts were amply supported by the evidence.

The Delegate further held that the surveillance evidence was properly admitted to assess credibility and that the ultimate burden of proving entitlement to benefits remains on the insured person.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits, medical benefits, and visiting expenses for his parents.

The insurer terminated benefits, arguing the applicant was not substantially disabled.

The arbitrator found the applicant lacked credibility, noting numerous inconsistencies in his medical history, functional abilities, and income reporting, which were further undermined by surveillance evidence showing him working and moving without apparent difficulty.

The arbitrator concluded the applicant did not suffer significant physical or psychological injuries as a result of the accident and dismissed all claims.

The applicant was injured in a motor vehicle accident and received statutory accident benefits until the insurer terminated them three years later.

The applicant sought ongoing weekly income benefits and medical expenses, arguing the accident materially contributed to her severe, ongoing disabilities, including multi-focal cranial dystonia and Sjogren's Syndrome.

The arbitrator found that while the accident exacerbated pre-existing neck and back pain, the applicant had recovered from the accident-related injuries by May 1994.

Her ongoing disabilities were attributed to the natural progression of pre-existing conditions and a severe adverse reaction to medication.

The arbitrator also excluded surveillance evidence obtained by investigators who entered the applicant's home under false pretenses, finding it unduly invasive of her privacy.

The claims for ongoing benefits were dismissed, but the applicant was awarded her arbitration expenses.

The applicant was seriously injured in a motor vehicle accident and received statutory accident benefits.

The insurer terminated her weekly income benefits after 156 weeks, arguing she was capable of returning to work.

The arbitrator found that the applicant suffered from chronic pain syndrome as a result of the accident and was continuously prevented from engaging in suitable employment.

The arbitrator ordered the insurer to pay ongoing weekly income benefits, denied the insurer's claim for repayment of an overpayment caused by its own error, and allowed the deduction of 80% of the applicant's actual post-accident earnings, but rejected the deduction of potential future income.

The applicant sought statutory accident benefits, including other disability benefits and housekeeping expenses, following a minor motor vehicle accident.

The arbitrator found that the applicant did not suffer a substantial inability to carry on his pre-accident household activities and dismissed the claims for ongoing benefits.

However, the arbitrator found that the insurer's notice of termination was slightly defective, entitling the applicant to a small payment of $105.71 for the notice period.

The arbitrator also found that the applicant had wilfully misrepresented his need for and receipt of housekeeping services, ordering him to repay $3,800 to the insurer.

The application was deemed frivolous, and the applicant was ordered to pay the insurer's $2,000 arbitration fee.