David Leitch

The applicant sought attendant care benefits following a motor vehicle accident.

After his representative withdrew, the applicant failed to attend the rescheduled pre-hearing and the arbitration hearing.

The arbitrator dismissed the claim for attendant care benefits due to the applicant's non-attendance.

The insurer was awarded $1,000 in expenses because the applicant was aware of the proceedings and the claim was deemed manifestly unfounded in the absence of supporting evidence.

The applicant was injured in a motor vehicle accident and elected to receive caregiver benefits after meeting with the insurer's adjuster.

She later sought to change her election to income replacement benefits, arguing the election was invalid because the adjuster failed to fully inform her of the consequences.

The arbitrator found that the insurer failed to comply with its obligation under section 32(2)(d) of the Statutory Accident Benefits Schedule to provide complete information, specifically that the benefit paying the most money might not pay for the longest period.

The election was deemed invalid, and the applicant was permitted to claim income replacement benefits.

Following earlier decisions regarding statutory accident benefits, the parties disputed the applicant's entitlement to interest on reinstated income replacement benefits and the quantum of hearing expenses.

The insurer argued the interest claim was res judicata because a special award had already been granted.

The arbitrator held that the applicant was entitled to interest under section 46 of the Schedule, finding the special award did not preclude a separate claim for interest.

The arbitrator also assessed the applicant's bill of costs, allowing deductions for premature motion expenses while denying other requested reductions, and remained seized of any remaining disputes.

The applicant was injured in a motor vehicle accident and claimed statutory accident benefits, including caregiver and housekeeping benefits, as well as medical expenses.

The insurer denied the claims, arguing the applicant was not the primary caregiver and that the expenses were not reasonable or necessary.

The arbitrator dismissed the applicant's claims, finding her evidence regarding the payment for caregiving and housekeeping services to be imprecise and inconsistent, thus failing to prove she incurred the expenses.

The claims for medical expenses were also dismissed as the applicant failed to prove how much OHIP would contribute.

The insurer's request for repayment of its assessment fee was denied because the application was not found to be frivolous or vexatious from the outset.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits, medical benefits for physiotherapy and chiropractic treatment, and expenses for treatment plans and family physician fees.

The insurer terminated income replacement benefits based on an orthopaedic assessment and disputed the other claims.

The arbitrator dismissed the applicant's claims, finding insufficient evidence to support her inability to work or the necessity of the disputed medical expenses.

The arbitrator also dismissed the insurer's claim for repayment of its assessment fee, concluding the arbitration was not frivolous or vexatious from the outset.

The applicant sought statutory accident benefits for acupuncture treatment following a motor vehicle accident.

The applicant failed to attend the arbitration hearing, and her representative successfully moved to withdraw from the record due to a loss of contact.

In the absence of any supporting evidence, the arbitrator dismissed the applicant's claims.

The insurer's request for the return of its assessment fee under s. 282(11.2) of the Insurance Act was denied, as the application was not shown to be frivolous or an abuse of process when commenced, but the insurer was awarded $1,500 in hearing expenses.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including weekly income benefits and supplementary medical and rehabilitation benefits.

The arbitrator found that the applicant failed to prove he was a self-employed musician prior to the accident, dismissing his claim for income replacement benefits.

The arbitrator also found that while the applicant suffered from chronic pain and depression, he did not suffer a substantial inability to perform his essential tasks, dismissing his claim for non-earner benefits.

The insurer was awarded its expenses for the arbitration.

The Applicant was involved in a motorcycle accident and claimed statutory accident benefits for damaged clothing.

The Insurer offered to pay the full amount but required the damaged articles and a completed application form before releasing the cheque.

The Applicant delayed providing the clothing and forms, leading to a dispute over interest and a special award.

The Arbitrator found that the Applicant was entitled to interest from the date he finally tendered the damaged clothing to the Insurer's adjuster until the date the Insurer paid the principal amount.

The Arbitrator dismissed the claim for a special award, finding the Insurer's conduct was not unreasonable.

The Insurer's request for the return of its arbitration assessment fee was denied, and the Insurer was ordered to pay $250 towards the Applicant's expenses.

The applicant sought to withdraw her application for arbitration regarding statutory accident benefits at the pre-hearing stage, intending to pursue the claim in an ongoing court action.

The insurer agreed to the withdrawal but sought an award for its assessment fee and arbitration expenses, arguing the application was an abuse of process due to venue-splitting.

The arbitrator found that the applicant's conduct was not an abuse of process, as the application was filed before case law strongly discouraged venue-splitting.

The insurer's request for costs and assessment fees was dismissed, and the applicant was permitted to withdraw her application unconditionally.

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

The insurer terminated benefits based on an orthopaedic surgeon's report that the applicant's ongoing disability was psychological and caused by a prior accident.

The applicant also received a temporary supplement from another insurer for the prior accident.

The arbitrator held that the insurer was entitled to deduct the temporary supplement from the income replacement benefits, as the applicant's inability to work was partly due to the prior accident.

However, the arbitrator also found that the insurer unreasonably delayed reinstating the income replacement benefits by relying on an orthopaedic surgeon's opinion regarding a psychological disability, and ordered the insurer to pay a special award of $2,060.67.

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

The insurer denied the benefits and required the applicant to attend an insurer's examination with a physiatrist.

The applicant failed to attend two scheduled appointments.

The insurer raised a preliminary issue that the applicant was precluded from proceeding to arbitration under section 50(b) of the Statutory Accident Benefits Schedule.

The arbitrator found that the insurer provided adequate notice, the applicant did not have a reasonable excuse for failing to attend, and the examination was reasonably necessary.

The applicant was precluded from proceeding to arbitration until he made himself reasonably available for the examination.

The applicant was injured in a motor vehicle accident and received income replacement benefits, which the insurer later terminated.

The applicant applied for arbitration.

Prior to the hearing, the insurer reinstated the benefits and did not contest entitlement at the hearing.

The applicant sought an order establishing her entitlement to benefits to gain procedural protection under section 287 of the Insurance Act.

The arbitrator held he had jurisdiction to issue the order and granted it.

The arbitrator also held that the applicant's accrued vacation pay must be included in the calculation of her income replacement benefit, distinguishing previous case law based on the applicant's history of taking vacation pay as contributions to a vacation account rather than as paid time off.

The applicant was involved in two motor vehicle accidents in April 2000.

She applied for statutory accident benefits from RBC Insurance for the first accident and from TTC Insurance for the second.

TTC argued that the applicant was required to claim benefits from RBC as the spouse of a named insured under section 268(5) of the Insurance Act.

The arbitrator held that the issue of whether the applicant was a spouse under the RBC policy was a priority dispute outside the jurisdiction of the Financial Services Commission of Ontario.

Pending resolution of the priority dispute in the proper forum, TTC, as the first insurer to receive the completed application for the second accident, was responsible for paying the benefits.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement, transportation, medication, and aqua therapy expenses.

The arbitrator dismissed all claims, finding the applicant failed to prove pre-accident income from self-employment and failed to provide sufficient medical evidence for the claimed expenses.

The arbitrator also rejected the applicant's constitutional arguments regarding production orders.

No special awards or costs were granted to either party.

Following a previous decision determining the applicant's entitlement to medical benefits, the parties could not agree on the quantum payable for treatment.

The arbitrator determined that the insurer must pay $3,070 plus interest for treatment received in accordance with the submitted treatment plans, finding that while the duration of treatment was significantly extended without new plans, the frequency and cost did not vary significantly from the estimates.

The arbitrator also ordered the insurer to pay the applicant's arbitration expenses, noting that the applicant achieved a more favourable outcome than the insurer's settlement offer and her claims were not frivolous.

The applicant applied for statutory accident benefits following a motor vehicle accident but failed to appear at the arbitration hearing.

His claims for income replacement, medical, and rehabilitation benefits were dismissed for lack of evidence.

The insurer sought an award under section 282(11.2) of the Insurance Act, alleging the claim was fraudulent and an abuse of process.

The arbitrator dismissed this request, finding the insurer failed to prove fraud from the outset on a balance of probabilities, as required to trigger the section.

However, the arbitrator awarded the insurer $4,776.02 in expenses under the Expense Regulation, as the applicant's failure to appear rendered his claims manifestly unfounded.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for treatment plans from a rehabilitation centre.

The insurer denied several treatment plans, relying on physiotherapy utilization guidelines rather than medical opinions, and delayed payments for initial treatments.

The arbitrator found the insurer unreasonably withheld and delayed payments, ordering payment of $1,285 for treatment and a special award of $1,223.63.

However, because the applicant flagrantly refused to comply with a pre-hearing order to produce pre-accident health records, the arbitrator denied the applicant's claim for arbitration expenses.

In a preliminary issue decision regarding statutory accident benefits, the arbitrator determined whether the applicant, a French-speaking person, was entitled to be assessed at a Designated Assessment Centre (DAC) by French-speaking assessors without interpreters.

The arbitrator found that the DAC was located in a designated area under the French Language Services Act and was obliged to provide services in French.

The Minister's Committee, which permitted DACs to use interpreters, bore the onus under section 7 of the Act to justify this limitation but failed to do so.

Consequently, the applicant's refusal to be assessed with an interpreter was reasonable, and he did not fail to make himself available for the DAC assessment.

However, as previously decided, he was not entitled to French-speaking assessors for the insurer's examinations and remained barred from arbitration until he attended those.

The applicant sought statutory accident benefits, including income replacement and medical benefits, following a motor vehicle accident.

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

Consequently, the arbitrator dismissed all of the applicant's claims for lack of evidence.

The insurer abandoned its claims for repayment of benefits, penalties, and expenses.

The applicant was injured while riding as a passenger on a streetcar and applied for statutory accident benefits, including non-earner benefits, housekeeping expenses, and transportation expenses.

The insurer denied the claims, and the applicant sought arbitration.

The arbitrator dismissed the applicant's claims, finding that medical evidence and surveillance contradicted his assertions of ongoing impairment and inability to perform pre-accident activities.

The arbitrator also found the applicant's evidence regarding transportation expenses unreliable.

Although the arbitrator declined to impose a penalty for a frivolous or vexatious proceeding, he awarded the insurer $1,250 in expenses because the applicant's claims were manifestly unfounded.