The applicant was injured in a motor vehicle accident and sought pre- and post-104 week income replacement benefits (IRBs), which the respondent insurer denied.
The Tribunal found that the applicant suffered a substantial inability to perform the essential tasks of his pre-accident employment as a sheet metal fabricator and airplane mechanic due to ongoing pain from a right leg fracture.
Furthermore, the Tribunal concluded that the applicant met the more stringent post-104 week test, as his chronic pain and physical limitations resulted in a complete inability to engage in suitable employment.
The Tribunal also ordered a 10% award against the insurer under s. 10 of O. Reg. 664, finding that the insurer unreasonably withheld benefits by failing to adjust the claim after receiving compelling medical reports supporting the applicant's ongoing impairments.
