Anne Sone

The Applicant, a self-employed truck driver, was injured in a motor vehicle accident and sought income replacement benefits from the Insurer.

The Insurer argued that the $3,000 per month the Applicant received from a private disability policy (NAL Insurance) was deductible as an income continuation benefit plan.

The Arbitrator found that the Applicant was 'employed' for the purposes of the Schedule and that the private disability benefits were calculated with reference to his income from employment.

Consequently, the private benefits were deductible, reducing the Applicant's income replacement benefit entitlement to $0.

The applicant's representative brought a motion to withdraw as counsel in an accident benefits dispute.

The representative adduced evidence of a complete breakdown in the solicitor-client relationship, noting that the applicant had moved, could not be reached, and did not respond to communications or the motion record.

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

The applicant was injured in a motor vehicle accident and sought medical and assessment benefits beyond the $3,500 Minor Injury Guideline (MIG) limit.

She argued that her pre-existing osteoporosis and alleged chronic pain syndrome removed her from the MIG.

The arbitrator found the applicant lacked credibility due to her refusal to answer questions regarding her opiate use and the suspension of her nursing licence.

The arbitrator rejected the applicant's expert evidence and concluded there was no compelling evidence that her pre-existing condition prevented maximal recovery within the MIG limits.

The claims for additional benefits were dismissed.

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

Following a breakdown in the relationship with his representatives, they were permitted to withdraw.

The applicant failed to attend a resumed pre-hearing despite receiving written notice that his claims could be dismissed if he did not appear.

The arbitrator dismissed the application for arbitration as frivolous, vexatious, or commenced in bad faith under Rule 68 of the Dispute Resolution Practice Code.

The applicant was ordered to pay the insurer's expenses fixed at $500.

Following a preliminary issue hearing where the arbitrator found the applicant was not injured in an 'accident' as defined in the Schedule, the insurer sought its expenses.

The arbitrator awarded the insurer its expenses, noting it was entirely successful in the preliminary hearing and the applicant's delay in providing productions necessitated a resumption of the pre-hearing.

The arbitrator reduced the insurer's claimed hours, applying a 3:1 ratio for preparation to hearing time, and disallowed the cost of transcripts.

The applicant was ordered to pay the insurer's expenses fixed at $11,557.90.

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

The applicant failed to attend the scheduled arbitration hearing despite receiving proper notice.

The arbitrator proceeded in the applicant's absence pursuant to Rule 37.9 of the Dispute Resolution Practice Code.

As the applicant presented no evidence, the application was dismissed and the applicant was ordered to pay $500 in expenses to the insurer.

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

The insurer refused certain benefits, leading to arbitration.

A preliminary issue hearing was held to determine if the applicant had the mental capacity to proceed in the dispute resolution process, following a previous finding that he lacked capacity.

Based on a new capacity assessment report by an occupational therapist, which concluded the applicant could manage his affairs, and the arbitrator's own observations, the arbitrator found that the applicant now has the mental capacity to proceed.

The applicant was catastrophically injured in a snowmobile accident and claimed attendant care benefits for services provided by her mother.

The insurer disputed the claims for periods when the applicant was hospitalized and when she lived with her boyfriend, and argued that a 2014 amendment to the Statutory Accident Benefits Schedule limited the benefit to the mother's economic loss.

The arbitrator dismissed the claims for the hospital and boyfriend periods, finding the applicant failed to prove economic loss and actual receipt of services, respectively.

However, the arbitrator held that the 2014 amendment did not apply retrospectively to limit the applicant's vested right to attendant care benefits.

Interest was awarded on overdue amounts, but the claim for a special award was dismissed as the insurer's conduct was not unreasonable.

The insurer brought a motion for an order permitting it to produce the accident benefits claim file of the applicant's daughter, who was struck by a vehicle in the same accident.

The insurer sought to introduce medical records from the daughter's file as evidence of the applicant's post-accident functioning to defend against the applicant's claim for non-earner benefits.

The arbitrator granted the motion, finding that the evidence was relevant and that the probative value outweighed any potential prejudice to the daughter, particularly since the applicant was the daughter's mother and legal guardian.

The applicant was injured in a motor vehicle accident while riding his bicycle.

He applied for accident benefits, initially electing a non-earner benefit, but later claimed entitlement to an income replacement benefit.

The arbitrator found that the applicant failed to prove he had a reasonable explanation for delaying his re-election.

Furthermore, the applicant did not meet the eligibility criteria for an income replacement benefit, as he was not employed for at least 26 weeks in the 52 weeks prior to the accident and was not receiving employment insurance benefits at the time of the accident.

The arbitrator also concluded that the applicant did not suffer a substantial inability to perform the essential tasks of his employment.

The claims for an income replacement benefit and a special award were dismissed.

The applicant was injured in a 2009 motor vehicle accident and sought statutory accident benefits.

The insurer denied the benefits and raised a preliminary issue that the applicant failed to commence arbitration within the two-year limitation period under s. 281.1(1) of the Insurance Act.

The applicant failed to attend the preliminary issue hearing.

The arbitrator found that the applicant bore the burden of proving entitlement and presented no evidence to show the arbitration was commenced within two years of the denial.

The application for arbitration was dismissed.

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) from the insurer.

She also received Canada Pension Plan (CPP) disability benefits and settled a long-term disability (LTD) claim for a lump sum that allegedly accounted for her CPP benefits.

On a preliminary issue, the applicant argued that the insurer should not be allowed to deduct CPP benefits from her IRBs, as this would result in a double deduction.

The arbitrator held that under the applicable Statutory Accident Benefits Schedule, the deduction of CPP disability benefits from IRBs is mandatory.

The insurer was therefore entitled to deduct the CPP benefits regardless of the LTD settlement terms.

The applicant, a two-year-old child, was injured in a collision with a Polaris ATV operated by a seven-year-old on vacant land.

The applicant sought statutory accident benefits.

The preliminary issue was whether the uninsured ATV was an 'automobile' under the Schedule, making the incident an 'accident'.

The arbitrator found that the ATV was an off-road vehicle required to be insured under the Off-Road Vehicles Act because the owner of the ATV was not an 'occupier' of the land where the collision occurred.

Therefore, the ATV met the statutory definition of an automobile, and the applicant was involved in an accident within the meaning of the Schedule.

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

After the applicant's legal counsel withdrew, the applicant failed to attend a motion and two scheduled pre-hearings without explanation.

The insurer sought dismissal of the proceeding.

The arbitrator dismissed the application for arbitration pursuant to Rule 68 of the Dispute Resolution Practice Code due to the applicant's failure to attend and failure to provide evidence supporting his claims.

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

After failing to attend two scheduled pre-hearings without explanation, the insurer sought to dismiss the proceeding.

The arbitrator found that the applicant and her representative were given proper notice of all proceedings as required by the Dispute Resolution Practice Code.

As the applicant bore the burden of proving entitlement to benefits and provided no evidence, the application for arbitration was dismissed.

The applicant was injured in a motor vehicle accident and subsequently pled guilty to dangerous driving causing bodily harm, receiving a conditional discharge.

The insurer denied income replacement and housekeeping benefits, arguing the applicant was excluded under section 30 of the Statutory Accident Benefits Schedule.

The arbitrator found that while the applicant was not 'convicted' of a criminal offence under subsection 30(2) due to the conditional discharge, he was 'found guilty' under subsection 30(4).

Consequently, the applicant was precluded from receiving benefits from the date of the accident until the date of his conditional discharge, and any benefits held in trust for that period were to be returned to the insurer.

However, he was not precluded from receiving benefits after the charge was finally disposed of.

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

After failing to attend a scheduled pre-hearing discussion and a subsequent resumption of the pre-hearing, the Arbitrator dismissed the Application for Arbitration.

The dismissal was ordered under Rule 68 of the Dispute Resolution Practice Code on the basis that the proceeding was frivolous, vexatious, or commenced in bad faith due to the Applicant's non-attendance.

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

After failing to attend multiple scheduled pre-hearings and failing to respond to communications from his representative and the Commission, the applicant's representative was permitted to withdraw.

The arbitrator dismissed the application for arbitration under Rule 68 of the Dispute Resolution Practice Code, finding the proceeding to be frivolous, vexatious, or commenced in bad faith due to the applicant's abandonment of the matter.

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

After failing to attend a scheduled pre-hearing discussion and failing to maintain contact with her representatives, the Arbitrator issued a notice of intent to dismiss the proceeding.

The Applicant did not respond to the notice, failed to attend the resumed pre-hearing, and did not provide an updated address.

The Arbitrator dismissed the Application for Arbitration as frivolous, vexatious, or commenced in bad faith under Rule 68 of the Dispute Resolution Practice Code.

The applicant's representative brought a motion to withdraw as counsel in a statutory accident benefits arbitration.

The representative submitted that the applicant was incarcerated and unreachable, resulting in a complete breakdown of the solicitor-client relationship.

The arbitrator granted the motion, finding that the representative had complied with the requirements of the Dispute Resolution Practice Code and that the inability to reach the applicant justified the withdrawal.