Alan Mervin

The applicant claimed statutory accident benefits following an alleged motor vehicle accident.

The applicant failed to attend the arbitration hearing.

The insurer sought dismissal of the claims and repayment of benefits paid, relying on a civil jury finding that the applicant was not in the vehicle at the time of the collision.

The arbitrator dismissed the applicant's claims and ordered her to repay $93,858.04 in income replacement benefits paid directly to her, finding they were obtained through wilful misrepresentation.

The arbitrator declined to order repayment of amounts paid to third-party service providers.

The applicant was also ordered to pay the insurer's arbitration expenses of $9,570.50.

The Applicant sought statutory accident benefits, including a determination of catastrophic impairment, income replacement benefits, housekeeping, and attendant care, following a 2003 motor vehicle accident.

The Insurer relied on extensive surveillance video taken over four years showing the Applicant driving on highways, running errands, and performing complex tasks, which starkly contradicted the Applicant's presentation to medical assessors and his family's testimony that he was severely cognitively and physically impaired.

The Arbitrator found the Applicant's medical evidence and family testimony unreliable due to the glaring inconsistencies with the objective surveillance evidence.

The Arbitrator preferred the Insurer's medical experts, concluded the Applicant was not catastrophically impaired, and dismissed all claims for benefits and a special award.

The Insurer requested an adjournment of the arbitration hearing after receiving new expert reports from the Applicant near the end of the 30-day period preceding the hearing.

The Arbitrator granted the adjournment to allow the Insurer to respond to the evidence.

The Applicant subsequently sought expenses incurred as a result of the adjournment.

The Arbitrator dismissed the Applicant's request for expenses, finding that while the Applicant complied with the strict timelines, serving the reports at the last possible moment severely prejudiced the Insurer's ability to respond.

As the Insurer was successful in obtaining the adjournment and did not request its own expenses, the Arbitrator ordered each party to bear its own costs.

The applicant was injured in a motor vehicle accident and sought a determination of catastrophic impairment.

The insurer's assessors concluded he did not meet the threshold, and the applicant sought funding for rebuttal reports.

The insurer denied funding, arguing the new SABS eliminated this right and the applicant failed to meet the timelines under the old SABS.

The arbitrator found the applicant was not entitled to substantive interim benefits for the reports under either SABS.

However, applying the 'whole case approach,' the arbitrator awarded $10,500 as an interim expense to fund the rebuttal reports, citing the applicant's financial distress and the need for procedural fairness to answer the insurer's expert reports.

The applicant's representatives, Lofranco Corriero, brought a motion to be removed as solicitors of record due to an irreparable breakdown in the solicitor-client relationship.

The applicant failed to provide instructions, refused to proceed with recommendations, and could not be contacted.

The insurer did not oppose the motion.

The arbitrator found that the representatives had complied with Rule 9.7 of the Dispute Resolution Practice Code and granted the motion to remove them as representatives of record.

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

After settlement discussions failed, the Applicant sought to withdraw her application for arbitration and close her file.

The Insurer raised concerns about the Applicant's capacity to enter into a settlement without legal advice.

The Arbitrator found the Applicant had the capacity to participate and permitted her to withdraw her application for arbitration without costs, with the consent of the Insurer.

The Applicant, injured in a motor vehicle accident, sought statutory accident benefits from the Insurer.

The Insurer refused to pay certain benefits, leading to an arbitration application.

The Applicant brought a motion for the production of the Insurer's complete log notes from the date of loss to the date the Application for Arbitration was filed.

The Insurer claimed litigation privilege over notes created after the first Application for Mediation.

The Arbitrator found that the Insurer has an ongoing obligation to adjust the file, and ordered the production of the adjuster's file up to the date of the Application for Arbitration, limited to the specific issues in dispute, subject to the Insurer providing a list of documents over which it asserts privilege.

The applicant's legal representatives brought a motion to be removed from the record due to a breakdown in communications, having lost contact with the applicant since March 2014.

The arbitrator granted the motion to withdraw.

The insurer also requested a production order for documents previously agreed to at a pre-hearing.

The arbitrator ordered the unrepresented applicant to produce the requested documents or provide proof of best efforts to obtain them by a specified date.

The parties settled the issues in dispute in the arbitration regarding a motor vehicle accident and requested a consent order regarding expenses.

The arbitrator issued a consent order requiring the applicant to pay $2,500 to the insurer and sign a full and final release for all past, present, and future claims.

The applicant was injured in a motor vehicle accident and the parties settled the issues in dispute.

A consent order was requested regarding expenses.

The arbitrator ordered, on consent, that the applicant pay $2,500 to the insurer and sign a full and final release for all claims.

The applicant was injured in a motor vehicle accident and received statutory accident benefits until the non-catastrophic policy limits were exhausted.

The applicant brought a motion for interim attendant care and medical/rehabilitation benefits in excess of the non-catastrophic limits, pending a determination of whether he suffered a catastrophic impairment.

The arbitrator dismissed the motion, finding no jurisdiction to order payments over the statutory non-catastrophic limits prior to a finding of catastrophic impairment.

Furthermore, the arbitrator held that the applicant did not meet the threshold test for interim benefits, as the conflicting medical evidence resulted in an ambiguous case strength.

The applicant sought to proceed to arbitration for income replacement benefits and housekeeping and home maintenance benefits after the two-year limitation period had expired.

She argued the limitation period should be tolled because she lacked capacity to instruct counsel due to severe substance abuse and cognitive impairments.

The arbitrator found the applicant was an unreliable historian and failed to rebut the presumption of capacity, precluding her claim for housekeeping benefits.

However, the arbitrator found the insurer's notices terminating income replacement benefits were confusing and not clear and unequivocal, particularly given the applicant's extremely low cognitive abilities.

Therefore, the limitation period for the income replacement benefits claim did not commence, and the applicant was permitted to proceed to arbitration on that issue.

The insurer brought a motion to compel the applicant to attend six insurer examinations to assess his entitlement to post-104 week income replacement benefits, and to stay the arbitration pending his attendance.

The insurer also sought production of the applicant's employment file from 2006 to date.

The arbitrator found that four of the six requested examinations were reasonable and necessary, given the late production of voluminous medical records by the applicant that raised new psychological and neurological issues.

The arbitration was stayed pending the applicant's attendance at the four examinations.

The arbitrator also ordered the applicant to produce his employment file, but limited the scope to one year pre-accident to date.

Following a mixed result in a statutory accident benefits arbitration, the parties sought their expenses.

The arbitrator reviewed the criteria under Rule 75.2 of the Dispute Resolution Practice Code.

Finding that each party was partially successful and that neither party's conduct unduly prolonged the proceeding, the arbitrator ordered that each party bear its own expenses.

The applicant's representatives, Tkatch and Associates, brought a motion to be removed as counsel of record due to a breakdown in communications.

The applicant had been receiving medical treatment in Kuwait and her representatives had been unable to contact her since June 2013.

The arbitrator granted the unopposed motion, removing the firm as solicitors of record and permitting service of the order to the applicant's last known mailing and email addresses.

The applicant applied for statutory accident benefits following a motor vehicle accident.

After mediation failed, the applicant applied for arbitration but failed to attend the pre-hearing discussion and the scheduled arbitration hearing, despite receiving proper notice.

The arbitrator dismissed the application for arbitration due to the applicant's non-attendance and failure to prove his claims.

The applicant was ordered to pay the insurer's legal expenses, fixed at $734.09, which included reasonable fees for a licensed paralegal.

The applicant's representative brought a motion to withdraw as counsel of record due to an inability to contact or receive instructions from the applicant since a pre-hearing discussion.

The insurer brought a cross-motion to compel production of agreed-upon documents.

The arbitrator granted the representative's motion to withdraw on the condition that all outstanding productions in the representative's possession be provided to the insurer, and any future documents received from prior requests be forwarded.

The issue of expenses was deferred to the hearing arbitrator.

Following an arbitration where the applicant's claims for statutory accident benefits were dismissed, the insurer sought its expenses.

The arbitrator found that the insurer was completely successful and that the applicant's conduct, including failing to comply with disclosure requirements and giving inconsistent histories to medical providers, unnecessarily prolonged the hearing.

The arbitrator awarded the insurer its expenses but reduced the requested hourly rate for counsel from $150.00 to $117.85, as the higher rate is only available to insured persons under the Dispute Resolution Practice Code.

The insurer was awarded $8,555.86 in fees, inclusive of HST, with no award for disbursements.

The applicant's legal representatives, Bergel, Magence LLP and Andrew Bergel, brought a motion to be removed as solicitors of record due to a material breakdown in the solicitor-client relationship.

The applicant had repeatedly failed to provide requested materials necessary to proceed with her statutory accident benefits claim.

The arbitrator found that the representatives had complied with the Dispute Resolution Practice Code requirements for withdrawal and granted the motion.

The applicant's legal representatives brought a motion to be removed as solicitors of record due to a material breakdown in the solicitor-client relationship.

The applicant had repeatedly failed to provide necessary information requested by his counsel.

The arbitrator found that the representatives had complied with the Dispute Resolution Practice Code and granted the motion to withdraw.