David Leitch

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

The applicant sought arbitration for ongoing income replacement benefits, treatment expenses, and a special award.

The arbitrator found that while the applicant's physical injuries had resolved, he suffered from an ongoing psychological disability caused by the accident, entitling him to ongoing income replacement benefits and psychological treatment expenses.

The arbitrator also granted a special award of $1,900, finding that the insurer unreasonably withheld benefits by deducting collateral benefits before they were actually available to the applicant.

The applicant was injured while a passenger on a bus and received statutory accident benefits.

The insurer terminated weekly income benefits and supplementary medical benefits in 1995.

The applicant sought reinstatement of weekly income benefits, and the insurer sought repayment of medical benefits paid for psychological treatment.

The arbitrator found that the applicant was physically and psychologically capable of returning to work by April 1995, dismissing the claim for ongoing weekly income benefits.

The arbitrator also dismissed the insurer's claim for repayment, finding the psychological treatment received prior to termination was reasonable and beneficial.

The applicant applied for statutory accident benefits following an alleged motor vehicle accident.

The insurer denied the claim on the basis that the applicant was not a passenger in a motor vehicle involved in an accident.

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

The arbitrator proceeded in the applicant's absence pursuant to the Statutory Powers Procedure Act and the Dispute Resolution Practice Code.

As the applicant provided no evidence to support his claim, the application was dismissed.

The applicants sought statutory accident benefits, alleging they were injured when their vehicle was rear-ended.

The insurer denied the claim on the basis that the accident was staged.

At the arbitration hearing on the preliminary issue of whether an accident occurred, the arbitrator accepted expert engineering evidence that the vehicle damage was inconsistent with a rear-end collision.

The arbitrator also found the applicant's testimony lacked credibility due to multiple contradictory statements in previous insurance claims.

The arbitrator concluded the applicants were not injured in the described accident and ordered the applicant to pay $2,000 in expenses for abuse of process.

The applicant was struck by a motor vehicle as a pedestrian and claimed statutory accident benefits for an orthopaedic mattress, motorized wheelchair, attendant care, and housekeeping expenses.

The insurer terminated benefits, arguing the applicant's ongoing symptoms were due to a pre-existing dependent personality and inactivity rather than the accident.

The arbitrator found the applicant suffered from reflex sympathetic dystrophy (RSD) triggered by the accident.

The arbitrator awarded the wheelchair rental cost and ongoing attendant care and housekeeping benefits at a reduced rate (50%), reflecting the applicant's pre-existing reliance on his family, but denied the claim for an orthopaedic mattress.

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

The insurer refused to pay income replacement benefits, alleging the applicant made a material misrepresentation regarding the ownership and use of the insured vehicles, relying on section 58(3)(a) of the Statutory Accident Benefits Schedule.

The arbitrator found that while misrepresentations were initially made, subsequent amendments to the policy prior to the accident rendered them immaterial to the risk at the time of the accident.

The insurer was therefore not entitled to rely on the exclusion to deny benefits.

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

The sole issue at arbitration was the interpretation of section 12(7) of the Schedule regarding the calculation of pre-accident gross weekly income.

The arbitrator held that he was bound by the Director's Delegate's decision in Scavuzzo, which established that only weeks during which income was earned are included in the averaging calculation.

The arbitrator concluded that the internal appeal system under the Insurance Act makes Director's decisions binding on arbitrators, despite any consensus among arbitrators favouring a different approach.

The applicant was injured in a motor vehicle accident and received weekly income benefits for 156 weeks.

The insurer terminated benefits, arguing the applicant's ongoing disability was due to pre-existing degenerative changes and that he was not continuously prevented from engaging in suitable alternative employment.

The arbitrator preferred the medical evidence attributing the applicant's chronic pain to the accident.

The arbitrator also accepted vocational evidence that the applicant lacked the education, training, and skills for the alternative jobs proposed by the insurer, and found the applicant was entitled to ongoing weekly income benefits.