Al Pace

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.

The insurer terminated his income replacement benefits and denied various medical, housekeeping, and assessment expenses.

The arbitrator found that the applicant suffered an impairment and was substantially unable to perform the essential tasks of his pre-accident employment, entitling him to ongoing income replacement benefits.

The arbitrator also awarded limited housekeeping benefits and the costs of certain medical assessments, but dismissed claims for additional medical and rehabilitation benefits.

A special award of 10% was granted against the insurer for unreasonably terminating the income replacement benefits and unreasonably denying payment for an assessment fee.

The applicant claimed statutory accident benefits for income replacement following two motor vehicle accidents in 1995 and 1996.

The insurer paid benefits for a period but subsequently terminated them.

The arbitrator found the applicant to be an unreliable historian who concealed prior workplace and motor vehicle injuries from his medical assessors.

Preferring the objective medical evidence of the insurer's experts, the arbitrator concluded that the applicant's ongoing shoulder and back problems were chronic pre-existing conditions and that he was no longer disabled as a result of the motor vehicle accidents.

The claim for further income replacement benefits was dismissed, but the applicant was awarded one-half of his arbitration expenses.