The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement, housekeeping, and attendant care benefits, which the insurer had terminated. The insurer argued the applicant had removed herself from the workforce prior to the accident due to pre-existing psychological issues. The arbitrator applied the material contribution test and found that the accident materially contributed to the applicant's pain disorder and exacerbated her depression and anxiety, resulting in a complete inability to engage in employment. The arbitrator awarded ongoing income replacement benefits and partial housekeeping benefits, but denied attendant care benefits and a special award, finding the insurer's reliance on its medical assessments was not unreasonable.
Financial Services Commission of Ontario
Neutral Citation: 2014 ONFSCDRS 36
FSCO A11-001877
BETWEEN:
M.T. Applicant
and
RBC GENERAL INSURANCE COMPANY Insurer
Before: Lloyd (J. R.) Richards
Heard: March 25, 26, 27, 28 and May 24, 2013, in Hamilton, Ontario. Written submissions were received on June 28, 2013.
Appearances: Daniel Roncari for M.T. Aldo Picchetti for RBC General Insurance Company