David Snider

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

The insurer placed her in the Minor Injury Guideline (MIG) and denied various medical benefits, income replacement benefits (IRBs), and non-earner benefits (NEBs).

The arbitrator found that the insurer consistently failed to comply with the notice requirements under the Statutory Accident Benefits Schedule.

As a result, the insurer was prohibited from taking the position that the MIG applied and was ordered to pay the claimed medical benefits, IRBs, and NEBs.

The arbitrator also found that the insurer unreasonably withheld or delayed payments and ordered a special award of 50 per cent of the amounts owed, plus interest.

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

The arbitrator dismissed the claims, finding the applicant's evidence and that of his medical experts lacked credibility.

Surveillance evidence contradicted the applicant's claims regarding his inability to drive and work.

The arbitrator concluded the applicant did not suffer a substantial inability to perform the essential tasks of his employment and that the disputed treatment plan was not reasonable or necessary.

The applicant was ordered to pay the insurer's arbitration expenses.

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

After several years of procedural steps and delays, the applicant withdrew all of her claims.

Both parties sought their expenses for the arbitration.

The arbitrator found that the insurer was completely successful due to the withdrawal of all claims and that the applicant's counsel had unduly delayed the process by failing to respond to correspondence.

The arbitrator dismissed the applicant's claim for expenses and ordered the applicant to pay the insurer's expenses in the amount of $10,244.44.

The Applicant was injured in a motor vehicle accident and applied for statutory accident benefits, including non-earner benefits and medical benefits, which the Insurer denied.

The Arbitrator found that the Applicant met the criteria for non-earner benefits, as the accident materially contributed to her complete inability to carry on a normal life, despite pre-existing depression.

The Arbitrator also found the Applicant was enrolled in a full-time post-secondary program at the time of the accident, entitling her to the enhanced student rate of $320 per week after 104 weeks.

The disputed treatment plans were deemed reasonable and necessary to assist the Applicant in coping with chronic pain.

The Insurer was ordered to pay the benefits, interest, and the Applicant's arbitration expenses.

Following a successful defence of an application for statutory accident benefits, the insurer sought its expenses for the arbitration hearing.

The arbitrator reviewed the insurer's bill of costs, noting that the rules for insurer's costs differ significantly from those for an insured.

The arbitrator reduced the claimed hourly rates to align with the Legal Aid Tariff and adjusted the ratio of preparation time to hearing time from 5:1 to 3:1.

Certain disbursements, including fees for a witness who did not testify and court reporter fees, were disallowed.

The insured was ordered to pay the insurer $16,115.96 for its expenses.

The applicant was injured in a motorcycle accident and applied for catastrophic impairment benefits, which the insurer denied.

The central issue was whether the applicant's impairments met the 55% Whole Person Impairment (WPI) threshold, with the insurer arguing that a pre-existing back condition accounted for a significant portion of his current disability.

The arbitrator rejected the insurer's expert evidence regarding the pre-existing condition and symptom magnification, finding the applicant's experts more reliable.

The arbitrator concluded that the applicant sustained a catastrophic impairment as a direct result of the accident and awarded him his full arbitration expenses.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs) at a rate of $400.00 per week.

The insurer paid IRBs at a rate of $308.74 per week, based on the applicant's declared self-employment income to the Canada Revenue Agency.

The arbitrator held that under section 4(5) of the Statutory Accident Benefits Schedule, the applicant is bound by the income declared for tax purposes, precluding him from claiming a higher income for IRB purposes.

The applicant's IRB entitlement was fixed at $308.74 per week, subject to future adjustment if his tax returns are reassessed.

Following a successful arbitration for statutory accident benefits, the applicant sought her expenses.

The arbitrator applied the criteria under section 12(2) of Ontario Regulation 664 and the principle of global assessment based on reasonableness.

Finding that the insurer unnecessarily prolonged the proceedings by relying on insufficient medical assessments and acting unreasonably, the arbitrator awarded the applicant her full claimed expenses of $13,369.99, inclusive of fees, disbursements, and taxes.

The applicant, who was injured in a 2009 motor vehicle accident, applied for arbitration regarding statutory accident benefits.

Following the applicant's reported death in 2015, no estate representative came forward.

The arbitrator issued a Notice of Intent to Dismiss, allowing 40 days for a response.

After receiving no reply from the applicant's family or estate, and upon the insurer's request, the arbitrator dismissed the applications for arbitration, finding the continued silence rendered the proceedings vexatious and an administrative burden.

The applicant was injured in two separate motor vehicle accidents and sought statutory accident benefits.

The parties purportedly reached a full and final settlement for both claims.

The applicant subsequently sought to rescind the settlement.

The arbitrator found that the Settlement Disclosure Notice provided by the insurer was defective because it failed to mention it covered both claims and omitted mandatory information regarding optional benefits.

As a result, the settlement was deemed void ab initio and set aside, allowing the applicant's arbitration to proceed.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits, which were denied by the insurer.

The parties failed to resolve their disputes through mediation, and a Report of Mediator was issued.

The applicant filed an Application for Arbitration more than two years after the denials and more than 90 days after the Report of Mediator was issued.

The arbitrator found that the application was filed beyond the limitation periods set out in the Insurance Act and the Statutory Accident Benefits Schedule.

The application for arbitration was dismissed.

The applicant was injured in a motor vehicle accident and sought payment for an occupational therapy assessment and treatment plan.

The insurer denied the plans and raised a late defence of double payment at the hearing.

The arbitrator rejected the late defence as trial by ambush and found no actual double payment occurred.

The arbitrator concluded the treatment plans were reasonable and necessary, noting the insurer's assessor admitted her recommendation might have differed had she received all relevant information.

The arbitrator ordered the insurer to pay for the plans, plus interest at 2% per month compounded monthly, and a special award of $5,500 for unreasonably withholding payment.

The applicant was injured in a motor vehicle accident and applied for a determination of catastrophic impairment.

The insurer failed to respond within the required 10-day period under s. 45(3) of the Statutory Accident Benefits Schedule.

The applicant argued that this failure should result in a deemed catastrophic impairment.

The arbitrator held that the Schedule does not contain a deeming provision for missing this timeline, unlike other sections.

The applicant was ordered to attend the insurer's s. 44 examinations to pursue the claim.

The parties resolved all substantive issues regarding statutory accident benefits prior to the arbitration hearing, leaving only the quantum of expenses to be determined.

The arbitrator reviewed the applicant's counsel's time dockets, disbursements, and settlement offers.

Finding the counsel's efforts reasonable and noting his 30 years of experience, the arbitrator awarded the maximum hourly rate of $150.

The insurer was ordered to pay $7,972.50 in fees, $478.35 in GST, and $4,213.47 in disbursements.

The applicant sought income replacement benefits and the cost of medical examinations following a motor vehicle accident.

The applicant failed to attend the arbitration hearing.

The arbitrator proceeded in his absence and found that the applicant had returned to full-time employment and earned in excess of the claimed benefit amount.

The arbitrator accepted the insurer's independent medical examination and rejected the applicant's medical reports due to factual errors and omissions.

The application was dismissed, and the applicant was ordered to pay the insurer's legal expenses.

The applicant was injured in a motor vehicle accident and sought payment for three chiropractic treatment plans under the Statutory Accident Benefits Schedule.

The insurer denied the plans, and the applicant applied for arbitration.

The arbitrator dismissed the application, finding that the treatment plans were neither reasonable nor necessary.

The arbitrator noted that the chiropractor's billing practices were invalid, the proposed 52-week plan violated professional guidelines, and the passive, palliative care was deemed harmful by other medical assessors.

The arbitrator also dismissed the claim for a special award, finding no bad faith by the insurer, and ordered each party to bear their own expenses.

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

The Insurer denied non-earner benefits, arguing the Applicant was precluded under section 30(1)(a) of the Schedule because he knew or ought reasonably to have known he was operating an uninsured vehicle.

Following a preliminary issue hearing, the Arbitrator ruled that the Applicant was not precluded from receiving non-earner benefits under the exclusion and ordered the matter to proceed to a hearing on the substantive issues.

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

The applicant applied for arbitration, claiming ongoing entitlement due to complete inability to engage in employment.

The arbitrator found that the accident materially contributed to the applicant's disability, exacerbating pre-existing injuries and causing chronic pain and depression.

The applicant was awarded income replacement benefits for both the pre- and post-104 week periods, along with interest and arbitration expenses.

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

The insurer had terminated benefits based on a Designated Assessment Centre report.

The arbitrator found the DAC report unreliable due to internal inconsistencies and miscommunication between its authors.

Based on the applicant's post-accident employment record as a television extra, the arbitrator determined she was entitled to income replacement benefits until October 2004, when she returned to her pre-accident earning capacity.

The arbitrator also awarded $640 for housekeeping expenses incurred before the two-year post-accident mark, plus interest and $100 in expenses.