David Muir

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to income replacement, medical, transportation, and housekeeping benefits.

The insurer had terminated income replacement benefits and denied the other claims.

The arbitrator dismissed the application, finding the applicant's evidence regarding his inability to work due to pain to be vague and unpersuasive, particularly given his continued employment for months post-accident and significant unexplained bank deposits.

The claims for medical, transportation, and housekeeping benefits were also dismissed due to a lack of supporting evidence.

The insurer brought a motion to stay the arbitration hearing until the applicant attended a section 42 insurer's examination.

The applicant refused to attend the examination unless she was permitted to videotape it, citing a prior injury during an assessment and cognitive deficits.

The arbitrator applied the principles from Bellamy v. Johnson and found that the applicant's insistence on videotaping the assessment was not an unreasonable refusal to attend, provided the recording is conducted with safeguards to ensure objectivity and minimize disruption.

The applicant was injured in a motor vehicle accident and sought income replacement and housekeeping benefits from his insurer.

The insurer terminated benefits, arguing the applicant failed to attend an insurer's examination and was no longer disabled.

The arbitrator found the applicant had a reasonable excuse for missing the examination due to confusing correspondence and language barriers.

The arbitrator awarded income replacement benefits for the initial period and up to February 17, 2004, finding insufficient evidence of disability beyond that date, as the applicant's leg numbness was likely a benign condition.

Housekeeping benefits were awarded at a reduced rate of $20 per week based on an in-home assessment, as the applicant's evidence regarding his pre-accident housekeeping was vague and unsupported.

The applicant's representative, Mazin Rooz Mazin, brought a motion to be removed from the record in a statutory accident benefits dispute.

The representative had lost contact with the applicant, who failed to attend two pre-hearings and the motion hearing despite being served.

The arbitrator granted the motion pursuant to Rule 9.8 of the Dispute Resolution Practice Code, finding that the representative was unable to obtain instructions.

The applicant's representative brought a motion to be removed from the record.

The applicant had failed to attend two pre-hearings without explanation and the representative had lost contact with him, rendering them unable to obtain instructions.

The Motor Vehicle Accident Claims Fund took no position.

The arbitrator granted the motion pursuant to Rule 9.8 of the Dispute Resolution Practice Code, finding that the applicant had notice of the motion and that the representative had made efforts to contact him.

The applicant's representative brought a motion to be removed from the record in a statutory accident benefits dispute.

The representative had lost contact with the applicant and was unable to obtain instructions despite serving notice of the motion at her last known address.

The applicant failed to attend two pre-hearings and did not appear at the motion.

The arbitrator granted the motion pursuant to Rule 9.8 of the Dispute Resolution Practice Code, removing the firm as the applicant's representative.

The applicant was injured in a motor vehicle accident and sought caregiver and housekeeping benefits under the Statutory Accident Benefits Schedule.

The insurer paid benefits initially but terminated them.

The arbitrator dismissed the application, finding the applicant's evidence regarding his pre-accident responsibilities and post-accident needs to be inconsistent, contradictory, and lacking credibility.

The applicant failed to establish on a balance of probabilities that he suffered a substantial inability to perform his caregiving and housekeeping duties.

The applicant, an 81-year-old man, was run over by his own vehicle, sustaining orthopaedic injuries.

He subsequently developed significant cognitive impairments.

The insurer denied catastrophic impairment benefits, arguing the cognitive decline was caused by a pre-existing subdural haematoma rather than the accident.

The arbitrator preferred the applicant's medical evidence, finding that the accident likely caused a minor head trauma that, combined with the pre-existing haematoma, resulted in brain edema and catastrophic impairment.

The applicant was awarded ongoing attendant care and housekeeping benefits.

The applicant commenced an arbitration for statutory accident benefits but subsequently failed to attend scheduled pre-hearings or maintain contact with his counsel.

The insurer brought a motion to dismiss the arbitration as frivolous, vexatious, or commenced in bad faith under Rule 68.1 of the Dispute Resolution Practice Code.

The arbitrator granted the motion, finding the application had effectively been abandoned, and awarded the insurer $500 in expenses.

State Farm brought a motion to adjourn or stay the arbitration hearing pending the applicant's attendance at a neurological assessment.

State Farm argued that fairness required the assessment to respond to late-filed expert reports from the applicant's neurosurgeon, relying on the underlying reasoning in F.S. and Belair rather than section 42 of the Statutory Accident Benefits Schedule.

The arbitrator dismissed the motion, finding that the hearing was still months away, State Farm had prior opportunities to assess the applicant, and fairness did not require an additional assessment outside the normal section 42 process at this time.

The insurer brought a motion seeking an order confirming its right to speak privately with members of a Designated Assessment Centre (DAC) assessment team to prepare them for an upcoming arbitration hearing, and an order that it was not obliged to disclose the details of those conversations.

The arbitrator dismissed the motion, finding that DAC assessors hold a unique, neutral statutory role in the dispute resolution process.

Maintaining the actual and perceived neutrality of DAC assessors outweighs concerns about hearing efficiency and witness preparation.

Consequently, there is no right to one-sided partisan contact with a DAC assessor prior to a hearing.

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

The insurer denied the claim under section 30(1)(a) of the Schedule, arguing the applicant knew or ought to have known she was operating an uninsured vehicle.

The arbitrator found that the applicant reasonably believed her former partner had renewed her insurance and was not wilfully blind to the fact that she was uninsured.

The insurer was not entitled to rely on the exclusion.

The applicant commenced an arbitration for statutory accident benefits but subsequently failed to participate or provide instructions to her counsel.

Her solicitors brought a motion to be removed from the record, and the insurer brought a motion to dismiss the arbitration.

The arbitrator granted both motions, removing the solicitors from the record and dismissing the arbitration as frivolous and vexatious due to abandonment.

The insurer was awarded $1,000 in expenses.

The applicant was injured in a motor vehicle accident and sought income replacement and housekeeping benefits from her insurer under the Statutory Accident Benefits Schedule.

The insurer terminated her income replacement benefits in February 2004.

At arbitration, the arbitrator found that the applicant's inability to work was primarily due to a pre-existing shoulder injury from a prior workplace incident, and there was insufficient medical evidence to prove the car accident caused an ongoing inability to perform her pre-accident employment beyond the termination date.

The claim for income replacement benefits was dismissed.

The arbitrator awarded a limited housekeeping benefit of $15.00 per week for a period of approximately five months following the accident, based on an occupational therapy assessment.

The applicant, who suffered an acquired brain injury in a motor vehicle accident, disputed the quantum of attendant care benefits paid by the insurer.

During pre-hearing discussions, the insurer sought to have the applicant undergo an in-home occupational therapy assessment and a neuropsychological assessment in Toronto pursuant to section 42 of the Statutory Accident Benefits Schedule.

The applicant objected, arguing the insurer was out of time and attempting to buttress its case for arbitration, and objected to the location and assessor for the neuropsychological assessment.

The arbitrator held that the insurer was entitled to the assessments, as nearly two years had passed since its last assessment and the request was not primarily strategic.

The arbitrator also found the choice of a neuropsychologist with adolescent expertise in Toronto was not unreasonable.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for Botox treatment for chronic pain and cervicogenic headache.

The insurer denied the treatment plan on the basis that the use of Botox for these conditions was experimental in nature.

At the arbitration hearing, the arbitrator weighed competing expert medical evidence regarding the efficacy and acceptance of Botox for chronic pain.

The arbitrator preferred the evidence of the applicant's expert, finding that the treatment is becoming an accepted therapy and is no longer experimental.

The arbitrator ordered the insurer to pay for the treatment and awarded expenses to the applicant.

The applicant, who suffered a moderate brain injury in a pedestrian motor vehicle collision, sought interim attendant care benefits after the insurer terminated them.

The insurer relied on a Designated Assessment Centre (DAC) report suggesting the applicant's need for supervision pre-dated the accident due to ADHD.

The arbitrator found significant flaws in the DAC report, including procedural irregularities and a failure to consider whether the accident exacerbated pre-existing vulnerabilities.

Finding that the applicant established a compelling prima facie case for entitlement and urgency due to safety risks, the arbitrator ordered the insurer to pay interim attendant care benefits pending a full arbitration hearing.

The applicant brought a motion to remove the insurer's counsel from the record on the basis that her prior employment as an arbitrator at the Financial Services Commission of Ontario raised a reasonable apprehension of bias.

The arbitrator dismissed the motion, finding that the passage of two and a half years since the counsel's departure from the Commission was sufficient to alleviate any reasonable concerns that the requirements of fundamental justice would not be met.

The applicant was found severely injured in a driveway between two houses with no memory of the incident.

He claimed statutory accident benefits, alleging he was struck by a motor vehicle.

The insurer denied the claim, arguing the injuries resulted from an assault.

After hearing extensive medical expert testimony regarding the pattern and severity of the injuries, the arbitrator concluded on a balance of probabilities that the injuries were consistent with a pedestrian-automobile collision and ruled that the applicant was involved in an 'accident' under the Schedule.

The insurer brought a motion to adjourn the arbitration hearing pending the outcome of its application for judicial review of a prior appeal decision regarding the deductibility of a pension plan.

The arbitrator dismissed the request for a lengthy adjournment, noting the absence of an automatic stay and the need for an expeditious process.

However, the arbitrator granted a short adjournment to allow the insurer time to review and respond to an accountant's report that the applicant had served late.