Insurer ordered to pay ongoing income replacement benefits to applicant suffering from intractable chronic pain.
The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them.
The applicant applied for arbitration, claiming a complete inability to engage in any employment due to intractable chronic pain resulting from the accident.
The arbitrator found the applicant and his expert witnesses credible, noting that the applicant had exhausted conventional medical treatments and required an intrathecal pain pump.
The arbitrator rejected the insurer's arguments that the applicant was merely 'de-conditioned' or drug-seeking, finding that the insurer had stereotyped the applicant.
The arbitrator concluded that the applicant suffered a complete inability to engage in any suitable employment and ordered the insurer to pay ongoing income replacement benefits and interest.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesNov 26, 2004
