Roy Raghunan

The applicant was injured in a motor vehicle accident while riding his bicycle.

The insurer paid income replacement benefits for 104 weeks but terminated them, arguing the applicant did not meet the more stringent test of complete inability to engage in suitable employment.

The arbitrator found the applicant, who was functionally illiterate in English and had a history of heavy physical labour, suffered from chronic pain and psychological impairments caused by the accident.

The arbitrator rejected the insurer's expert evidence that the applicant was malingering, finding instead that he was completely disabled from working.

The applicant was awarded ongoing income replacement benefits.

However, his claim for a multidisciplinary pain management program was dismissed as he failed to prove it was reasonable and necessary, given a previous similar program had not yielded further recovery.

The appellant appealed an Arbitrator's decision dismissing his claims for income replacement benefits, medical expenses, and housekeeping benefits following a motor vehicle accident.

The Arbitrator had dismissed the claims primarily based on adverse credibility findings, noting inconsistencies between the appellant's reported symptoms and surveillance evidence showing him driving for extended periods.

The Director's Delegate dismissed the appeal, finding that the Arbitrator's factual conclusions were supported by the evidence and did not constitute an error of law.

The Arbitrator reasonably preferred the respondent's expert evidence and rejected the appellant's experts due to their reliance on the appellant's subjective and exaggerated complaints.

The applicant sought income replacement benefits, medical benefits for physiotherapy and massage therapy, and the cost of various assessments following a motor vehicle accident.

The arbitrator dismissed all claims, finding the applicant entirely lacking in credibility due to numerous contradictions regarding his pre-accident health, employment duties, living arrangements, and the accident itself.

Surveillance evidence and independent medical examinations demonstrated significant symptom magnification and inconsistent effort.

The arbitrator concluded the applicant did not suffer a substantial inability to perform his employment tasks and that the claimed medical treatments and assessments were not reasonable or necessary.

The applicant sought caregiver benefits following a minor motor vehicle accident, claiming physical and psychological impairments substantially disabled her from caring for her young daughter.

The arbitrator dismissed the claim, finding the applicant lacked credibility and failed to provide objective medical evidence of a substantial inability to perform caregiving duties.

Surveillance evidence and inconsistencies in testimony further undermined her claim that she incurred caregiving expenses.

The applicant was ordered to pay the insurer's arbitration expenses due to the unmeritorious nature of the claim.

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits, including income replacement, medical, housekeeping, and examination expenses.

The insurer terminated income replacement benefits, arguing the applicant was malingering.

The arbitrator reviewed extensive medical evidence, surveillance footage, and the applicant's testimony.

The arbitrator found the applicant lacked credibility, noting inconsistencies between his claimed severe impairments, such as a driving phobia, and surveillance showing him driving for hours.

The arbitrator concluded the applicant was exaggerating his symptoms for financial gain and was capable of returning to work.

All claims for benefits and expenses were dismissed.

The applicant claimed statutory accident benefits, alleging she was a passenger in a vehicle involved in a collision in a mall parking lot.

The insurer denied the claim, asserting she was not in the vehicle.

After hearing evidence from the applicant, the driver, the other driver, and the investigating police officer, the arbitrator found the applicant's evidence implausible and contradictory.

The independent witnesses confirmed no women were in the vehicle.

The arbitrator concluded the applicant was not involved in the accident, dismissed her claims for benefits and a special award, and ordered her to repay interim benefits with interest.

Finding the claim abusive and vexatious, the arbitrator also ordered the applicant to pay the insurer's $1,000 assessment fee.

The applicants, two brothers, were injured in a motor vehicle accident and sought weekly income benefits from their insurer.

The insurer terminated benefits in the summer of 1992.

Following an arbitration hearing, the arbitrator determined the applicants' pre-accident weekly incomes and calculated their respective benefit amounts.

Based on medical and psychological evidence, the arbitrator found that one applicant was disabled from his job as a bodyshop helper until December 30, 1992, and the other was disabled from his job as a cleaner until April 30, 1993.

Claims for repayment by the insurer and a special award by the applicants were dismissed due to a lack of evidence.

The applicants were awarded their arbitration expenses.