Neutral Citation: 1996 ONICDRG 134

OIC A95-000334

ONTARIO INSURANCE COMMISSION

BETWEEN:

USHA SETHI

Applicant

and

ALLSTATE INSURANCE COMPANY OF CANADA

Insurer

DECISION

Issues:

The Applicant, Usha Sethi, was injured in a motor vehicle accident on October 16, 1992. She applied for and received statutory accident benefits from Allstate Insurance Company of Canada ("Allstate"), payable under Ontario Regulation 672.¹ Weekly income benefits were terminated by Allstate on March 28, 1995. The parties were unable to resolve their disputes through mediation and Mrs. Sethi applied for arbitration under the Insurance Act, R.S.O. 1990, c.I.8, as amended.

The issues in this hearing are:

1. Is Mrs. Sethi entitled to weekly income benefits pursuant to section 12 of the Schedule from March 29, 1995 onwards?

Mrs. Sethi also claims interest on any amounts owing, and her expenses incurred in the hearing.

Result:

1. Mrs. Sethi is not entitled to further weekly income benefits.

2. Mrs. Sethi is not entitled to her expenses.

Hearing:

The hearing was held at the offices of the Ontario Insurance Commission in North York, Ontario, on June 24, 25, 26, and 27, 1996, before me, Joyce Miller, arbitrator.

Present at the Hearing:

Applicant:

Usha Sethi

Mrs. Sethi's Representative:

Elliott A. Zeitz Barrister and Solicitor

Allstate's Representative:

Theodore P. Charney Barrister and Solicitor

Allstate's Officer:

Tony Cioffi

Irene Kasprzyk

Witnesses:

Mrs. Usha Sethi

Ms. Patricia Embro

Dr. Kharak Singh Grewal

Dr. Xenia R. Kirkpatrick

Dr. Arthur Ameis

Interpreter: Mr. Ken Mann interpreted the Punjabi language

Court Reporter: Mr. Paul Warner recorded the proceedings

Exhibits: 11 exhibits were filed

Evidence and Findings:

Background

Mrs. Sethi, who is 56 years old, was born in India. In 1971 she emigrated to Canada with her husband and two sons. Their first place of residence was in Brampton, Ontario. Mrs. Sethi had completed grade 10 in India. She took a six-month Manpower course to upgrade her English, as well as a sewing course. For a short time she worked in a "sewing factory."

In 1973 Mrs. Sethi began to work for Consumers Glass in Brampton. Her job was to pack glass jars. The essential tasks of her job required her to stand for seven hours a day and pack bottles as they rapidly came off a conveyor belt. Most of her weight was on her left leg as she needed to press a pedal with her right foot to move the packed boxes along the conveyor line. She generally packed boxes of six, 12 or 24 jars. Sometimes she had to carry packed boxes over to a table. Mrs. Sethi worked an eight-hour shift. She had two 15 minute breaks and one-half hour for lunch. She testified that the factory environment was very noisy.

In 1977 Mrs. Sethi and her family moved to the Hamilton area and she transferred to the Consumers Glass branch in Hamilton. She worked part-time until 1979 when she became a full-time employee.

In 1985 Mrs. Sethi divorced her husband. In 1988 she moved back to Brampton to be with her family. However, she continued to commute to Consumers Glass in Hamilton, a trip of one to one and a half hours each way. At the time of the accident, Mrs. Sethi was considering transferring back to the Brampton branch.

The accident occurred on October 16, 1992. Mrs. Sethi was driving west along the QEW when a tractor-trailer cut her off. She braked and her car was hit from the rear. Her car spun around and her vehicle was hit again on the driver's side. Mrs. Sethi had to be removed from the right side of the car. She was taken to Joseph Brant Memorial Hospital by ambulance.

The emergency record shows that Mrs. Sethi had been wearing a seat-belt and complained of pain in the front and back of the left side of her chest and left hip. As well, she complained of numbness in her left leg.

Mrs. Sethi did not return to work after the accident. She was paid weekly benefits of $537.10 (except for 26 weeks covered by a disability insurer) until March 28, 1995.

Mrs. Sethi testified that as a result of her injuries from the accident, she is unable to return to work. She stated that she was suffering from left-sided body pain starting from her head and radiating down the left side of her body to her left foot. Allstate's position is that Mrs. Sethi's pre-accident condition, and not the car accident, is the cause of her present physical complaints.

Pre-Accident Medical History

Mrs. Sethi's employment file² and medical records³ reveal a significant pre-accident history of health-related problems. From 1980 until the accident in 1992, her employment records show that Mrs. Sethi was continually off work for substantial periods of time because of health problems.

For example, in 1980 Mrs. Sethi was off work in February for a few weeks because of a car accident. She was also off for several weeks in April because she slipped and fell, and hurt her left knee. At the end of July she was off again for a few days because of a swollen left leg.⁴

In 1981 Mrs. Sethi was off work for almost a half a year. Her employment record shows various reasons for her absenteeism. They include: a sore leg, abdominal pain, therapy for her back, and surgery on October 26, 1981.⁵

In 1982 and 1983 Mrs. Sethi was on a temporary lay-off.

In 1985 Mrs. Sethi was off work for several months because of an accident at home where she injured her left arm and left buttock.⁶

In 1986 Mrs. Sethi was off work for the month of January due to backache and left arm pain.⁷ She was also off work again that year from June until the second week in October because of a fall downstairs at home, where she injured her right knee and left leg.⁸

In January 1987 she was off work for about two weeks.⁹ A visit to Dr. Grewal, her family physician since 1984, shows that along with the flu, she was suffering from left buttock tenderness. Visits to Dr. Grewal on the 14th and 21st of January note left buttock and thigh pain.¹⁰

In 1987 Mrs. Sethi was also off work for about six weeks in October and November.¹¹In her claim to Great-West Life for disability benefits, Dr. Grewal notes that she was suffering from asthma, dizziness, chest pain, headache, and toothache.¹²

In 1989 she saw a specialist in rheumatology, Dr. Belcon, for pain in her left shoulder radiating to the arm and her hand, including numbness in her left arm.¹³In 1990 she saw Dr. Voitk, a surgeon, who noted the following:

This is a 50 year old lady with a one year complaint of pain, numbness and tingling in her left hand, shooting up to the elbow and up to the shoulder. She initially describes the onset as associated with some swelling around the elbow. It seems that both the forefinger and thumb are involved in fine work where she lacks sensation and there is also pain in the ringfinger and little finger.¹⁴ [emphasis added]

In January 1991 Mrs. Sethi saw a neurologist, Dr. Zaitlen, for a "sensory disturbance in the hands," which was more in the left than in the right hand. He noted that there were no obvious related factors or precipitant, except for her job and housework.¹⁵

On April 3, 1992 Dr. Farmilo, the company physician, noted in a letter to Dr. Zaitlen that since 1987, Mrs. Sethi "... had a number of musculo skeletal complaints, primarily of her left wrist and shoulder. The pain and numbness of the left hand started May 1989. The distribution of numbness and decreased pin prick has always been unusual." ¹⁶[Emphasis added] Dr. Farmilo goes on to state that: "For several months, she has been selecting bottles on the lightest lines. There is no work in the plant that is available to her that is not highly repetitive. ... Please advise me as to whether she is fit to continue working."

In April 1992, Dr. Zaitlen noted that Mrs. Sethi "... still complains of pain in the wrist, ulnar hand and thumb and numbness in the hands." He also noted that she was waiting for a response to a "WCB claim" and that he was "on hold for the claim" with respect to making any treatment arrangements.¹⁷

The clinical notes and records of Dr. Farmilo indicate that on April 22, 1992, Mrs. Sethi was on modified work and that surgery on her left hand had been recommended by Dr. Zaitlen. Dr. Farmilo goes on to note that Mrs. Sethi was afraid to have the surgery and has not booked it.¹⁸

The clinical notes and records of Dr. Grewal show that in July 1992, Mrs. Sethi was complaining of headache, back pain, body pain, and leg pain. She also complained of left buttock pain. Dr. Grewal found tenderness in her left sacroiliac joint.¹⁹

On September 17, 1992 Dr. Grewal's clinical notes and records show Mrs. Sethi was complaining of left chest pain. His examination noted "pain left side chest, slight swelling left side chest pectoral area." He recommended that she have a mammogram.²⁰

Dr. Farmilo's clinical notes and records of September 28, 1992 indicate that Mrs. Sethi was still suffering from pain in her neck, shoulder and radiating to her hand. He notes that she is reluctant to have surgery.²¹

On October 8, 1992, 10 days before the accident Mrs. Sethi saw Dr. Grewal for left chest pain and left hand numbness. Dr. Grewal notes that the mammogram was normal and on examination he found Mrs. Sethi's left chest wall to be tender.²²

These are mere highlights of an extensive pre-accident medical history. The OHIP summary, from 1987 until 1992, indicates that Mrs. Sethi has averaged about 30 to 40 medical visits a year. The summary shows that in 1989 Mrs. Sethi had 50 medical visits. In 1990 she attended 44 medical appointments. In 1991, the year before the accident, she had 54 medical visits.²³

Mrs. Sethi's employment record indicates that she was off work for various health-related problems on an average of three to four months a year from 1986 to 1991.

Dr. Grewal's clinical notes and records show that Mrs. Sethi has been seeing him about every two weeks since 1984. As well, his clinical notes and records indicate a pre-accident history not only of asthma and migraine headaches, but also a history of left-sided body pain and numbness in her left arm and leg.²⁴

Mrs. Sethi was cross-examined, in great detail, about her previous medical history and absenteeism from work. Although her employment file showed that she had received a number of written reprimands from her employer for her excessive absenteeism, Mrs. Sethi denied receiving the letters. Mrs. Sethi consistently responded that she did not recall any events that caused her to be absent from work, nor did she recall any lengthy periods of absenteeism from work.

According to Mrs. Sethi, her present physical problems are different than the ones she had before the accident.

Dr. Grewal testified that Mrs. Sethi only had a few aches and pains before her car accident, but they had grown worse because of the accident. He stated that she is presently unable to work because of her constant pain, the swelling in her feet and the tingling and numbness in her left arm. He attributes her present condition to the car accident.

I give little weight to Dr. Grewal's testimony that Mrs. Sethi had only a few aches and pains before the accident. His own clinical notes and records clearly contradict this conclusion.

Ms. Patricia Embro, a co-worker of Mrs. Sethi testified that she worked side by side with Mrs. Sethi packing bottles from 1989 until the accident in 1992. She stated that because she and Mrs. Sethi worked closely together, they got to know each other very well.

Ms. Embro testified that Mrs. Sethi was a good worker and that there was nothing unusual about her attendance at work or her abilities to get the work done. She stated that Mrs. Sethi never complained of health problems. She noted, however, that Mrs. Sethi had asthma and used an inhaler.

I give no weight to Ms. Embro's testimony. The objective evidence is quite clear that Mrs. Sethi had a very high rate of absenteeism from 1980 until the accident. As well, the evidence shows that Mrs. Sethi was on modified work because of significant physical problems other than asthma. If Ms. Embro worked next to Mrs. Sethi, she should have been aware of this.

The evidence of Dr. Kirkpatrick and Dr. Ameis will be discussed in the Analysis and Findings below.

ANALYISIS AND FINDINGS

The issue in this arbitration is whether Mrs. Sethi is eligible for weekly income benefits pursuant to subsections 12(1) and 12(5)(b) of the Schedule.

In order to receive weekly income benefits under subsection 12(1), Mrs. Sethi must establish, on a balance of probabilities, that she suffered a substantial inability to perform the essential tasks of her occupation, as a result of the October 16, 1992 motor vehicle accident.

Under subsection 12(5)(b) Mrs. Sethi must establish, on a balance of probabilities, that three years after the accident, her injuries continuously prevent her from engaging in any occupation or employment for which she is reasonably suited by education, training, or experience.

The test under subsection 12(5)(b) is significantly stricter than the test applied for the first 156 weeks of disability. During the first three years of a claim for weekly benefits, eligibility is based upon the insured person's ability to perform the job held at the time of the accident. After three years of disability, the scope of the test widens to other jobs that may be suitable for the person.

An important element in discharging the burden of proof under subsections 12(1) and 12(5)(b) is showing that the motor vehicle accident significantly or materially contributed to an insured person's disability. Succinctly, an insured person has the burden of establishing the necessary causal connection between the accident and his or her disabilities.

For the following reasons I find that Mrs. Sethi has not discharged her burden of proof.

The Causation Issue

In my view, Mrs. Sethi has deliberately downplayed her pre-accident condition in order to promote the view that her present physical problems are as a result of the car accident. In reporting her pre-accident condition to various medical practitioners that she saw after the accident, Mrs. Sethi was clearly dishonest. The following are some examples:

• A report by the Canadian Back Institute (CBI) on January 6, 1993, notes that Mrs. Sethi "... claims that prior to this accident she never had any history of low back, neck or left shoulder problem. "²⁵

• A report by Dr. Newal l, on March 11, 1993, for Aetna Life Insurance Company of Canada (Aetna), Mrs. Sethi's employment insurer, notes that "... she denies having had any previous back, leg or similar symptoms of the sort of which she now complains."²⁶

• On February 3, 1994, Dr. Anderson of the Whiplash and Headache clinic, notes that "Prior to the accident this very pleasant 53 year old Indian woman was well."²⁷

• On February 28, 1994, an Independent Medical Examination (IME) was performed by Dr. Tepperman. In his report he notes that except for a history of asthma, "... She was otherwise well before the accident."²⁸

• On March 15, 1994 Mrs. Sethi told Dr. Ross, of the Whiplash & Headache Clinic, that a few hours after the accident, "... she began to experience pain in the low back, hip, neck, head and left arm and leg." He goes on to note that "... prior to the motor vehicle accident, she never experienced any of these problems before."²⁹

• On November 21, 1994, Mrs. Sethi underwent an IME examination by Dr.Ameis, a physiatrist. In his report Dr. Ameis noted "[Mrs. Sethi] ... denies any serious problems before the accident ...when I pointed out to her the older records of Dr. Zaitlin [sic], she acknowledged that indeed she had seen him at least once in prior years for hand injuries. She insists that there is nothing else to that information: that she is [sic] perfectly healthy. She would have headaches once or twice a year."³⁰

• On February 3, 1995 Mrs. Sethi told Dr. Kirkpatrick, a psychiatrist, who examined her on behalf of Allstate, that before the accident, she was "..in good health except for medication-controlled asthma, occasional mild headaches and "some little, little other problems."³¹

• In a report dated June 30, 1995, Dr. Alcock, a psychologist, who examined Mrs. Sethi at the request of her lawyer, notes under the heading of 'General Health', "Ms. Sethi enjoyed good health during her childhood and adolescence. She was absent from work due to a gall bladder operation (six months) in 1980. She also took off six to eight weeks for a urinary tract-related operation in 1990. Her asthma has also caused her to take days off at a time, every two to three months."³²

Mrs. Sethi's dishonesty to the post-accident doctors included not only her account of her pre-accident physical condition, but also her ability to understand English. Dr. Kirkpatrick, a psychiatrist who examined Mrs. Sethi on behalf of Allstate noted in her report that "Because of her limited command of English,[Mrs. Sethi] was examined with the assistance of a professional interpreter..."³³ and "Because of Mrs. Sethi's very limited command of English, a detailed cognitive assessment was not attempted."³⁴ [Emphasis added]

In contrast, Dr. Alcock, who performed a psychological assessment at the request of Mrs. Sethi's counsel noted in his report "[Mrs. Sethi's] receptive and expressive English was good and for most of the interview, she did not require translation from her son."³⁵

In my view, by downplaying her ability to understand English, Mrs. Sethi was deliberately attempting to thwart a full assessment by Dr. Kirkpatrick.

Mrs. Sethi was also dishonest about her injuries immediately after the accident. As noted above, Mrs. Sethi told Dr. Ross that a few hours after the accident

"... she began to experience pain in the low back, hip, neck, head and left arm and leg."[emphasis added] This description of her injuries at the time of the accident is clearly contradicted by the clinical notes and records of Dr. Grewal as well as her own application for accident benefits.

Dr. Grewal saw Mrs. Sethi on October 19, 1992, three days after the accident. His diagnosis was that Mrs. Sethi was suffering from "chest and left thigh spasm."³⁶On October 23, 1992, Dr. Grewal filled out a medical report form for Allstate. His diagnosis was that Mrs. Sethi was suffering from "chest wall, left breast and left thigh spasm."³⁷

On November 3, 1992, Mrs. Sethi applied for accident benefits. In her application, under the heading of "Nature and Extent of Injuries Sustained as a Result of Accident," she noted that she sustained "chest wall an[d] thigh muscular pain."

On November 18, 1992, Dr. Grewal filled out a form for disability benefits from Aetna. In the form under the heading "List any diagnoses or complications which are prolonging the patient's disability," Dr. Grewal wrote only one word: "sprain."³⁸

In 1995, however, in support of an application for CPP by Mrs. Sethi, Dr. Grewal noted that Mrs. Sethi's "condition has not changed" from the motor vehicle accident and that "... she still complains moderate to severe neck, left arm, back, left leg, chest pain and headaches."³⁹ [emphasis added]

In my view, for the purpose of obtaining disability benefits, Mrs. Sethi has created a story whereby her pre-accident physical condition was that of a healthy person with a few aches and pains and that the car accident has resulted in serious injuries which disabled her from continuing to work.

The objective evidence, however, clearly shows that Mrs. Sethi had a very high rate of absenteeism from work from 1980 until the accident. She saw her family doctor, for various health problems, at least once every two weeks from 1984 until the accident. The OHIP summary shows that Mrs. Sethi attended 54 medical appointments the year before the accident.

The objective evidence is also clear that prior to the accident, Mrs. Sethi had a long-standing problem with respect to the left side of her body. These problems have been recorded in Dr. Grewal's clinical notes and records. By the spring of 1992, Mrs. Sethi was on modified work because she was having physical difficulties in performing her work. She had applied for WCB benefits because of her inability to do her job. She was contemplating having surgery on her left hand.

The discrepancies and contradictions in Mrs. Sethi's evidence regarding her pre-and post-accident physical condition are numerous. I find that she has not presented any credible evidence to link her injuries from the car accident to her alleged present physical problems.

I prefer the evidence of Dr. Ameis, a physiatrist, who examined Mrs. Sethi on behalf of Allstate.

Dr. Ameis testified that Mrs. Sethi was not honest about her pre-accident medical history.⁴⁰ As well, she was not honest about her present condition. He noted that when he examined her the test results were inconsistent. In his report he notes the following examples:

...The patient is cautious on heel and toe gait although there is no biomechanical reason. The same caution does not exist when she is coming off the examining bed onto the stool or when she walks in and out of the office. There is no pathology in the hips.

Deliberately miscuing the patient during the sitting straight leg raise test, by telling her that I am examining her knee: there is no SLR pain on the left side.

The same test is done again in the supine position, cueing [sic] the patient that I am testing her for straight leg raise in regard to her back. At barely 30 degrees, the patient finds the pain intolerable, and this intolerance continues when we attempt to do a combined hip and knee flexion. The latter has nothing to do with straight leg raise. The former was demonstrated as pain free, in precisely the same test but in a different position and with miscuing.

Having demonstrated that she was intolerant of even light touch or any physical exertion in the left arm, the patient unconsciously showed surprising strength and reliance on the left arm as she moved around the examining bed....

... this patient's automatic movement, reflecting her usual daily activities do not incorporate any feature consistent with the intensity of pain and disability otherwise claimed.

Having shown me virtually no internal rotation of the left shoulder, beyond barely touching the buttock, I noted that when I asked the patient where her back hurt during testing, that she unhesitatingly provided substantial internal rotation to point to the mid-back.

Dr. Ameis testified that in his view, Mrs. Sethi's pain magnification was conscious and deliberate. He stated that the problems that Mrs. Sethi complains of are not consistent with the injuries she received at the time of the accident.

In his report, Dr. Ameis notes:

... it would appear that this was not a very important car accident, in terms of causing this patient any harm. Such injuries as did occur, in the form of contusions and minor strains, likely cleared within a matter of weeks. Certainly within 3 months, this patient should have been back to work. The reasons for her not going back to work after that time, but instead creating an intense, left-sided hemialgesia and an equally intense invalid role cannot be found through physical examination and will not respond to physical treatment.

I accept Dr. Ameis' analysis of Mrs. Sethi's condition.

As noted above, Dr. Grewal's clinical notes and records and Mrs. Sethi's application for disability benefits indicated that Mrs. Sethi had very minor injuries as a result of the accident. The objective evidence revealed that Mrs. Sethi had a significant pre-accident history of medical problems. The evidence also showed that Mrs. Sethi deliberately misrepresented her pre-accident medical condition. Dr. Ameis' report leads me to conclude that Mrs. Sethi has also deliberately misrepresented the extent of her present alleged physical problems.

For all of the above reasons, I find that Mrs. Sethi has not presented any credible evidence on the relevant and material elements of her claim to link any of her alleged present physical problems to the minor injuries she received in the car accident.

Accordingly, I find that Mrs. Sethi is not entitled to weekly income benefits pursuant to section 12 of the Schedule.

Expenses

Having determined that Mrs. Sethi was not credible on the material elements of her claim, I exercise my discretion⁴¹ not to award Mrs. Sethi her expenses.

Order:

1. Mrs. Sethi is not entitled to weekly income benefits either pursuant to sections 12(1) or 12(5)(b) of the Schedule.

2. Mrs. Sethi is not entitled to her expenses incurred in respect of the arbitration.

August 8, 1996

Joyce Miller Arbitrator

Date

Footnotes

1. 1Prior to January 1, 1994, Ontario Regulation 672 was called the No-Fault Benefits Schedule. After that date it became the Statutory Accident Benefits Schedule — Accidents Before January 1, 1994. In this decision, the term "Schedule" will be used to refer to Regulation 672.
2. 2Exhibit 1, Employment Brief of Usha Sethi
3. 3Exhibit 2, Medical Brief; Exhibit 3, Insurer's Supplementary Brief
4. 4Supra note 2 at Tab 4, Employment file contents for the year 1980, including absentee and tardiness record and job posting application.
5. 5Ibid, Tab 5, Employment file for the year 1981, including absentee and tardiness record, claim documentation and correspondence.
6. 6Ibid, Tab 9, Employment file contents for the year 1985, including absentee and tardiness record, claim documentations and correspondence.
7. 7Ibid, Tab 10, Employment file contents for the year 1986, including absentee and tardiness record and claim documentation and correspondence. See Dr. Grewal's diagnosis in application for disability benefits to Great West Life.
8. 8Ibid.
9. 9Supra note 1, Tab 11, Employment file contents for the year 1987, including absente and tardiness record, claim documentation and correspondence.
10. 10Supra note 3, Tab 27, clinical notes and records of Dr. Grewal.
11. 11Supra, note 9.
12. 12Ibid.
13. 13Exhibit 4, letter from Dr. Belcon to Dr. Grewal, dated November 7, 1989.
14. 14Exhibit 9, letter dated December 17, 1990 from Dr. Voitk to Dr. Grewal.
15. 15Supra note 3, Tab 23, letter dated January 31, 1991 from Dr. Zaitlen to Dr. Grewal.
16. 16Exhibit 7, letter dated April 3, 1992 from Dr. Farmilo to Dr. Zaitlen.
17. 17Supra note 15, letter dated April 7, 1992 from Dr. Zaitlen to Dr. Grewal.
18. 18Exhibit 8, Clinical notes and records of Dr. Farmilo.
19. 19Supra note 3, Tab 27, the clinical notes and records of Dr. Grewal.
20. 20Ibid.
21. 21Exhibit 8, Clinical notes and records of Dr. Farmilo.
22. 22Supra note 3, Tab 27, the clinical notes and records of Dr. Grewal.
23. 23Supra note 3, Tab 28, OHIP summary from 1987 to 1995.
24. 24Supra note 3, Tab 27, clinical notes and records of Dr. Grewal.
25. 25Supra note 3, Tab 7, Report of Canadian Back Institute dated January 6, 1993.
26. 26Supra note 3, Letter from Dr. J.R. Newal dated March 11, 1993 at p. 2.
27. 27Supra note 3, Tab 19, report of Dr. Anderson dated February 3, 1994.
28. 28Supra, tab 20.
29. 29Supra note 3 Tab 26, Report of Dr. Ross dated March 15, 1994 at pp. 1 and 2.
30. 30Supra note 3, Tab 29, Report of Dr. Arthur Ameis, dated December 20, 1994.
31. 31Supra note 3, Tab 31, Report of Dr. Xenia R. Kirkpatrick, dated March 20, 1995 at p. 1. 32
32. 32Supra note 3, Tab 34 at p. 4. Report of Dr. James E. Alcock, dated June 30, 1995 at p. 4.
33. 33Supra note 3, Tab 31, Report of Dr. Kirkpatrick, dated March 20, 1995 at p. 1.
34. 34Ibid, at p. 4.
35. 35Supra note 3, Tab 34, Report of Dr. Alcock dated June 30, 1995.
36. 36Supra note 3, Tab 27, Clinical notes and records for October 19, 1992.
37. 37Ibid, Tab 2, Ontario Insurance Medical or Psychological Report, dated October 23, 1992.
38. 38Ibid, at p.2.
39. 39Supra note 3, Tab 30, letter form Dr. Grewal dated February 6, 1995.
40. 40Supra note 30.
41. 41Section 282(11) of the Insurance Act. See also Ralph McCormick and Economical Mutual Insurance Company (October 2, 1991), OIC A-000139.