Anne L. Sone

The applicants sought statutory accident death benefits after the deceased was crushed by a truck flatbed while dismantling it for parts in a scrap yard.

The insurer denied the claim on the basis that the incident was not an 'accident' under section 2(1) of the Statutory Accident Benefits Schedule.

The arbitrator held a preliminary issue hearing to determine if the incident met the definition of an accident.

Applying the purpose and causation tests, the arbitrator found that dismantling a flatbed for parts is not an ordinary and well-known activity to which automobiles are put.

Furthermore, the deceased's actions with a torch and pry bar constituted an intervening act that broke the chain of causation.

The arbitrator concluded that the deceased was not fatally injured as a result of an accident and dismissed the claim for benefits.

The insurer brought a motion to compel production of the applicant's complete Ontario Works file, including his Ontario Disability Support Pension file, from the Ministry of Community and Social Services.

The applicant consented to the order.

The arbitrator found that the requirements under Rule 67.7 of the Dispute Resolution Practice Code were met, as reasonable efforts had been made to obtain the documents, the Ministry had a reasonable opportunity to respond, and the documents were relevant to the applicant's claim for income replacement benefits.

The motion was granted.

The applicant was injured when he slipped on ice while exiting his vehicle to escape an out-of-control salt truck sliding towards him.

The insurer denied statutory accident benefits, arguing the incident did not meet the definition of an 'accident' under section 2(1) of the Schedule.

The arbitrator found that exiting a vehicle is an ordinary use of an automobile and that the impact of the salt truck directly caused the applicant's impairment.

The arbitrator concluded that the applicant was involved in an 'accident' and is entitled to claim benefits.

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

After the applicant failed to attend two scheduled pre-hearings and his counsel withdrew from the record, the insurer requested that the proceeding be dismissed.

The arbitrator found that the applicant had effectively abandoned his case and dismissed the proceeding as vexatious pursuant to Rule 68.1 of the Dispute Resolution Practice Code.

The applicant sought statutory accident benefits for caregiving, housekeeping, and medical expenses following a motor vehicle accident.

The arbitrator dismissed all claims, finding the applicant's evidence regarding her inability to perform caregiving and housekeeping tasks to be inconsistent, contradictory, and lacking credibility.

Surveillance evidence showed the applicant performing tasks she claimed to be unable to do.

The arbitrator preferred the medical evidence of the insurer's assessors over the applicant's practitioners.

The claim for medical benefits was also dismissed as the applicant admitted she did not receive the recommended chiropractic treatments, and further massage therapy was deemed not reasonable or necessary.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits, which the insurer terminated.

The applicant sought arbitration.

During the proceedings, the applicant's representative was found to have a conflict of interest and withdrew.

After being given time to find new representation, the applicant and the insurer ultimately signed a consent to dismiss the arbitration without costs.

The arbitrator dismissed the issues in the arbitration hearing based on the consent of the parties.

The applicant was injured in a motorcycle accident and suffered a severe wrist fracture and hip injury.

The insurer terminated his income replacement benefits after 104 weeks, relying on a designated assessment centre report and a transferable skills analysis suggesting he could work in alternative occupations.

The arbitrator found the insurer's vocational assessments flawed as they failed to adequately consider the applicant's physical limitations, the need for extensive retraining, and the significantly lower remuneration of the suggested jobs.

Relying on a vocational assessment obtained by the applicant, the arbitrator concluded that the applicant suffered a complete inability to engage in any employment for which he was reasonably suited by education, training, or experience.

The applicant was awarded ongoing income replacement benefits and interest.

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

The parties resolved the substantive issues prior to a scheduled preliminary issue hearing, but the issue of arbitration expenses remained in dispute.

The insurer argued that the arbitrator lacked jurisdiction to award expenses because no hearing on the merits had taken place.

The arbitrator held that under the Insurance Act and the Dispute Resolution Practice Code, the Commission has explicit jurisdiction to decide a claim for expenses in relation to a matter that has been resolved prior to a preliminary issue hearing.

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

The insurer terminated benefits, and the applicant commenced arbitration.

Subsequently, the applicant was deported to Bulgaria and failed to attend scheduled insurer's medical examinations.

The insurer brought a preliminary motion to dismiss the arbitration for failure to diligently pursue the claim and for an award of its assessment fee under s. 282(11.2) of the Insurance Act.

The arbitrator declined to dismiss the arbitration, noting the applicant's stated willingness to attend an examination upon return to Canada or in Bulgaria, and ordered a resumption of the pre-hearing to monitor the applicant's efforts to return.

The arbitrator also denied the insurer's request for the assessment fee, finding the arbitration was not frivolous, vexatious, or an abuse of process when commenced.

The applicant was injured in a pedestrian motor vehicle accident and received statutory accident benefits until the insurer terminated weekly income benefits.

The applicant applied for arbitration but failed to attend the hearing or maintain contact with her legal representatives, who were permitted to withdraw.

Proceeding in her absence, the arbitrator accepted the insurer's uncontested medical evidence that the applicant did not suffer from a physical or psychological impairment preventing her from working.

The claim for benefits was dismissed, and the applicant was ordered to pay the insurer's legal expenses of $1,636.95, though the arbitrator declined to order the applicant to pay the insurer's filing fee as the initial claim was not frivolous or vexatious.