• FAIR – supporting auto accident victims through advocacy and education
  • FAIR – supporting auto accident victims through advocacy and education
  • FAIR – supporting auto accident victims through advocacy and education

IME

Waldock and State Farm [+] Arbitration, 2014-11-10, Reg 403/96. Preliminary Issue FSCO 4315.

http://www.fairassociation.ca/wp-content/uploads/2015/12/Waldock-and-State-Farm-Preliminary-issue-FSCO-4315.pdf

Dr. Cashman’s assessment was deficient in several areas.  As earlier stated, I find that these deficiencies fail to support the position of State Farm in refusing to accept the assessment that Mr. Waldock is catastrophically impaired.  During cross-examination of Dr. Waisman, counsel for State Farm, perhaps inadvertently, emphasized that Dr. Cashman’s assessments did not follow the requirements of the Schedule and the AMAGuides.  Thus, I find I must give a little weight to Dr. Cashman’s assessments (as expressed in his written report), for there is no evidence offered by the insurer to contradict Dr. Waisman’s evidence.

Waldock and State Farm  [+] Arbitration, 2015-11-16, Reg 403/96. Expenses FSCO 4689.

In my decision on the preliminary issue, issued on November 10, 2014, I referred to the oral evidence of Dr. Waisman wherein he was critical of the report prepared and submitted by Dr. Cashman to State Farm.  State Farm relied upon Dr. Cashman’s report to deny that Mr. Waldock had suffered a catastrophic impairment.  State Farm did not bring Dr. Cashman as a witness to that Hearing and thus, I found that his report was untested and less credible evidence than that of Dr. Waisman and his colleagues at Multidisciplinary Designated Assessment Centre (“MDAC”), including Dr. Ameis.

Arbitrator orders rare special award against insurer

Emily Casey of Tkatch & Associates says the lesson to be learned is that it is not enough for the insurer to have reports stating the claimant is not impaired catastrophically. She notes State Farm did not have its medical expert attend the hearing and that forced the arbitrator to give less weight to State Farm’s medical arguments.

“Standing by a flawed report in denying catastrophic benefits resulted in a significant punitive award,” she says.

Comments are closed.