Bruce Robinson

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

The Insurer terminated weekly income benefits, but after mediation, the parties settled for a specific period and the Applicant signed a release.

The Insurer argued the release barred future claims and that the two-year limitation period had expired.

The Arbitrator found the release was confined to the specific period settled at mediation and did not bar future claims.

Furthermore, the limitation period had not begun to run because the Insurer failed to provide clear and unequivocal written notice of its refusal to pay benefits after the settlement, as required by the Schedule.

The Applicant was permitted to proceed to arbitration.

The Applicant was injured in a motor vehicle accident and claimed weekly income benefits under section 12 of the Statutory Accident Benefits Schedule, arguing she was employed as a nurse at the time of the accident.

The Insurer argued she was unemployed and entitled to benefits under section 13.

The Applicant worked on a casual, on-call basis for two nursing agencies and was not on an assignment when the accident occurred.

The arbitrator found that the Applicant was not employed at the time of the accident, as she had no guarantee of work, was not receiving salary, and had not worked the required 180 days in the preceding 12 months to qualify under section 12(3).

Therefore, the Applicant was entitled to benefits under section 13.

The applicant was injured in a motor vehicle accident and received statutory accident benefits until August 1992.

She applied for mediation and arbitration in 1994 and 1995.

The insurer argued the application was barred by the two-year limitation period under section 281(5) of the Insurance Act.

The arbitrator found that the insurer's letters did not constitute clear and unequivocal written notice of refusal to pay benefits as required by section 24(8) of the Schedule.

Therefore, the limitation period never started to run, and the applicant was entitled to proceed to arbitration.

The applicant was struck by a car and claimed statutory accident benefits.

He sought weekly income benefits under section 12 of the Schedule, claiming he was self-employed as a tailor.

The arbitrator found the applicant failed to prove he was employed or self-employed at the time of the accident, as he had declared no income and admitted to avoiding work.

The applicant alternatively claimed ongoing non-earner benefits under section 13.

Relying on consistent specialist medical evidence that the applicant had recovered and was exaggerating his symptoms, the arbitrator concluded the applicant did not suffer a substantial inability to perform his essential tasks.

The claims for ongoing benefits were dismissed, but the applicant was awarded his arbitration expenses.

The applicant was injured in a motor vehicle accident and received weekly income benefits.

He subsequently returned to work intermittently, earning substantial post-accident income.

The insurer argued that 80% of all post-accident income should be deducted from benefits on a 'carry forward' basis, applying excess earnings against future benefits.

The arbitrator rejected this approach, finding it would act as a disincentive to rehabilitation and returning to work.

Instead, the arbitrator held that post-accident income must be matched directly to the specific weekly income benefit payable in the week it was earned, with no carry forward of any excess.