3 total
Claims for income replacement and caregiver benefits dismissed due to lack of credible evidence and objective medical support.
The applicants were injured in a motor vehicle accident and claimed statutory accident benefits from the insurer, including income replacement benefits, caregiver benefits, and taxi expenses.
The arbitrator found that the insurer was liable to pay benefits as there was no other available insurance.
However, the arbitrator dismissed the claims for income replacement benefits, finding that neither applicant had a legitimate contract of employment evidenced in writing at the time of the accident, and the female applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident self-employment.
The claims for caregiver benefits and taxi expenses were also dismissed due to a lack of objective medical evidence and failure to prove the expenses were reasonably incurred.
The applicants were awarded one-third of their arbitration expenses.
Post-156 week income benefits terminated after brief work-hardening extension due to symptom embellishment and residual capacity.
The applicant was injured in a motor vehicle accident and received statutory accident benefits for 156 weeks.
The insurer terminated weekly income benefits at the three-year mark.
The applicant sought ongoing benefits under section 12(5) of the Schedule, claiming continuous inability to engage in suitable employment due to soft tissue injuries, fibromyalgia, and depression.
The arbitrator found evidence of symptom embellishment and concluded the applicant was capable of sedentary work or returning to his previous administrative courier duties.
The arbitrator awarded a brief extension of benefits for a four-month 'work hardening' period, terminating on January 29, 1994.
Arbitrator awards $3,948.20 in arbitration expenses to applicant following settlement of accident benefits dispute.
The applicant sought reimbursement for arbitration expenses totaling $20,971.11 following a settlement with the insurer regarding accident benefits.
The arbitrator reviewed the claimed expenses, which included agent's fees, expert witness fees, medical reports, and miscellaneous disbursements.
The arbitrator reduced the agent's fees, noting that preparation time prior to the hearing was excessive and not fully compensable under the schedule.
Claims for transcripts, transportation, laser printer rental, and an accountant's report were denied or reduced for lack of connection to the arbitration or insufficient proof.
The insurer was ordered to pay $3,948.20 in outstanding expenses.
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