Nicholas W. Fursman

The applicant was injured in a motor vehicle accident and received income replacement benefits for 104 weeks.

The insurer terminated benefits on the basis that the applicant did not meet the post-104 week test of suffering a complete inability to engage in any suitable employment.

The arbitrator found that the applicant failed to make a bona fide effort to find suitable alternative employment and intentionally limited his job search.

Furthermore, surveillance evidence and inconsistencies in the applicant's testimony severely undermined his credibility regarding his alleged chronic pain and deterioration.

The arbitrator concluded that the applicant failed to establish a prima facie case of total disability and that the insurer had identified suitable alternative occupations.

The application for ongoing income replacement benefits was dismissed.

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

The insurer denied the claim, alleging that the accident was staged and that the applicant was not employed prior to the accident.

The arbitrator found that the accident was genuine, the applicant was employed, and the insurer had no credible evidence to support its allegations of fraud.

The applicant was awarded income replacement benefits, medical benefits, and a special award of $15,000 because the insurer unreasonably withheld payments.

The applicant sought statutory accident benefits following a motor vehicle accident.

The insurer denied the claim, alleging the accident was staged and the applicant's employment was fabricated.

At the arbitration hearing, the insurer's key witness recanted his previous statements implicating the applicant.

Before the decision was issued, the insurer brought a motion to re-open the hearing under section 39 of the Dispute Resolution Practice Code to introduce new evidence from another witness.

The arbitrator dismissed the motion, finding that the insurer failed to exercise due diligence in discovering the evidence prior to the hearing and that the proposed hearsay evidence lacked sufficient credibility to affect the outcome.

The insurer was ordered to pay the applicant's expenses for the motion.