Caroline King

The Applicant was injured in a motor vehicle accident and subsequently entered into a settlement agreement for statutory accident benefits.

Years later, his litigation guardian challenged the settlement, arguing either that the Applicant's father forged his signature or that the Applicant lacked capacity to contract.

The Arbitrator found that the Applicant likely signed the documents himself.

However, relying on extensive medical records showing the Applicant was involuntarily hospitalized for psychosis hours after signing, and an uncontradicted capacity assessment, the Arbitrator concluded the Applicant lacked capacity to contract both when signing and during the statutory cooling-off period.

The settlement was therefore declared not binding.

The applicant sought a non-earner benefit following a motor vehicle accident, claiming he suffered a continuous complete inability to carry on a normal life.

The arbitrator found the applicant lacked credibility regarding his pre-accident health, as medical records indicated pre-existing neck pain, numbness, and depression.

The arbitrator concluded the applicant failed to prove that the accident materially contributed to his impairments or that any such impairments continuously prevented him from engaging in substantially all of his pre-accident activities.

The application for non-earner benefits, along with claims for a special award, expenses, and interest, was dismissed.

The applicant sought statutory accident benefits, including caregiver benefits, attendant care benefits, and the cost of a psychological assessment, following a motor vehicle accident.

The arbitrator dismissed all claims, finding the applicant lacked credibility due to pervasive inconsistencies in his evidence regarding his employment status, living arrangements, and caregiving responsibilities.

The arbitrator concluded the applicant's self-reports to assessors were unreliable, undermining the medical reports supporting his claims.

The applicant sought income replacement benefits following a 2005 motor vehicle accident.

The applicant's representative, an unlicensed agent previously found by the Law Society to lack good character, appeared at the hearing without instructions from the applicant, who had moved to Ethiopia and ceased participating.

The arbitrator excluded the representative for lacking competence and instructions.

The application was dismissed as an abuse of process due to the applicant's prolonged non-participation and failure to comply with production orders.

The representative was ordered to personally pay $1,000 in expenses to the insurer for needlessly prolonging the proceeding.

The insurer requested an expense hearing after successfully defending against the applicant's claims for statutory accident benefits.

The arbitrator found the applicant's evidence wholly lacking in credibility and that his conduct prolonged and obstructed the hearing.

The arbitrator ordered the applicant to pay the insurer's expenses in the amount of $14,988.86, comprising disbursements and legal fees.

The applicant sought statutory accident benefits following a motor vehicle accident.

After her counsel was removed from the record, the applicant failed to attend the scheduled arbitration hearing despite receiving proper notice.

As no evidence was adduced to support her claims, the application was dismissed.

The insurer was awarded $1,500 in expenses for needlessly preparing for and attending the hearing.

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

A dispute arose and the applicant applied for mediation.

The parties agreed to extend the mediation date beyond the 60-day statutory limit but failed to comply with the mandatory procedural steps under Rule 19.3 of the Dispute Resolution Practice Code.

The applicant filed for arbitration before the scheduled mediation date.

The arbitrator held that because the parties did not comply with the mandatory procedural steps to extend the mediation timeline, the agreement to extend was invalid.

Consequently, mediation was deemed to have failed at the expiry of the 60-day limit, which occurred before the arbitration application was filed.

The applicant was therefore entitled to commence the arbitration proceeding.

The Applicant was injured as a pedestrian in a motor vehicle accident and sought statutory accident benefits.

She submitted a treatment plan for a neuropsychological assessment totaling $5,028.50.

The Insurer paid $2,200, arguing the work constituted a single assessment capped at $2,000 plus $200 for the OCF-18 form.

The Applicant argued the work constituted two separate assessments, entitling her to an additional $2,000.

The Arbitrator found that the two reports submitted had the same purpose, author, and tests administered, and therefore constituted a single assessment under the Schedule.

The application for the remaining balance and interest was dismissed.

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

She had a rare, pre-existing brainstem cavernoma that was symptomatic prior to the accident.

The insurer argued the post-accident deterioration was the natural progression of her condition.

The arbitrator found that the applicant did not suffer pre-accident loss of consciousness and accepted the applicant's expert evidence that the torsional force of the collision likely caused increased bleeding in the cavernoma.

The arbitrator concluded that the accident materially contributed to the impairment, tipping the balance from a mild impairment to a life-threatening condition.

The Applicant sought arbitration for a disputed medical benefit of $820.00 following a motor vehicle accident.

The Insurer raised a preliminary issue, arguing the Applicant was precluded from proceeding because he failed to attend a scheduled section 44 insurer examination.

The Arbitrator found that the Insurer had the right to choose the assessor and that the notice provided was compliant with the Schedule.

Because the Applicant failed to attend the examination without reasonable cause, he was barred from commencing mediation under section 55 of the Schedule, and consequently precluded from arbitrating the issue under section 280(2) of the Insurance Act.