Deborah Pressman

The appellant appealed an arbitrator's decision dismissing his application for arbitration regarding an outstanding account for a catastrophic rebuttal report from a service provider.

The arbitrator found that the appellant had previously settled his accident benefits claim on a full and final basis and that the true claimant was the service provider, which lacked standing to commence arbitration in the insured's name.

The Director's Delegate confirmed the arbitrator's decision, holding that the service provider had no standing and that the prior settlement precluded further claims since the appellant had not rescinded the settlement or returned the funds.

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

The applicant's legal representatives brought a motion to withdraw due to a breakdown in the solicitor-client relationship, as they had been unable to reach the applicant for several months.

The applicant failed to attend the hearing despite receiving notice.

The arbitrator granted the motion to withdraw, dismissed the application for arbitration due to the applicant's failure to participate and prove his claims, and ordered the applicant to pay the insurer's expenses fixed at $1,000.

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

After a dispute arose, the applicant applied for mandatory mediation, which was delayed for over a year.

On the scheduled date, the mediator determined that mediation did not take place and closed the file without issuing a Mediator's Report.

The applicant subsequently applied for arbitration.

The insurer raised a preliminary issue, arguing the applicant was precluded from proceeding to arbitration under section 281(2) of the Insurance Act because mediation had not failed.

The arbitrator found that the mediation failed by statutory definition when the agreed time for mediation expired without a settlement.

The arbitrator exercised discretion to waive the requirement for a Mediator's Report, allowing the applicant to proceed to arbitration, and awarded the applicant $1,500 in expenses.

The applicant sought arbitration for a catastrophic impairment determination and medical benefits following a motor vehicle accident.

The insurer raised preliminary issues, arguing the applicant failed to attend and submit to a psychiatric insurer examination and that her claims were barred by issue estoppel due to a previous arbitral decision.

The arbitrator found the applicant's behaviour at the examination, while challenging, did not amount to a failure to attend and submit, as the examination was abruptly terminated by the assessor.

The arbitrator also declined to apply issue estoppel, noting catastrophic impairment was not decided in the previous proceeding.

The issue of res judicata for specific medical benefits was deferred to the hearing arbitrator.

The applicant was awarded her expenses for the preliminary hearing.

The applicant sought expenses following a successful arbitration and subsequent appeal regarding her entitlement to income replacement benefits and the applicable interest rate.

The arbitrator awarded the applicant her requested expenses of $3,559.50, noting her complete success on appeal and the insurer's late reinstatement of benefits which caused the applicant to incur legal expenses.

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

The parties disputed two treatment plans, and the applicant applied for arbitration.

On the eve of the hearing, the applicant requested to withdraw his application.

The insurer insisted on expenses of $9,000.00.

The arbitrator permitted the withdrawal but found that the late stage of the request warranted an award of expenses to the insurer.

The arbitrator fixed the insurer's expenses at $1,500.00, noting there were only two minor issues in dispute and no cost outline was provided for the $9,000.00 claim.

The insurer brought a motion for the production of the applicant's Canadian Police Information Centre (CPIC) record.

The applicant claimed that psychological impairments from a motor vehicle accident caused him to commit acts of domestic violence, resulting in criminal charges.

The arbitrator found that the applicant had made his criminal conduct an issue in the arbitration, making the CPIC record relevant and reasonably necessary.

The motion was granted, and the applicant was ordered to produce his CPIC record from one year prior to the accident to the present.

TD Home and Auto Insurance Company applied to vary a consent order to deduct long-term disability benefits received by the insured from her income replacement benefits (IRB).

The arbitrator granted the variation, finding that the insured's subsequent receipt of disability benefits from Sunlife constituted a material change in circumstances and new evidence.

The arbitrator held that the disability benefits were deductible under the Statutory Accident Benefits Schedule as payments under an income continuation benefit plan.

The arbitrator also rejected the insured's argument that her legal expenses incurred in obtaining the Sunlife benefits should be deducted from the collateral benefits amount, as the Schedule does not provide for such a deduction.

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

Following a breakdown in the relationship, the applicant's representative brought a motion to be removed from the record.

The insurer brought a motion to dismiss the arbitration due to the applicant's failure to participate.

The applicant did not attend the motions despite receiving notice.

The arbitrator granted the representative's motion to withdraw and dismissed the arbitration.

The applicant applied for statutory accident benefits following a motor vehicle accident.

After mediation failed, she applied for arbitration at the Financial Services Commission of Ontario.

The applicant's counsel withdrew prior to the hearing, and the applicant failed to appear or communicate with the Commission.

The arbitrator proceeded in the applicant's absence and dismissed the application, as the applicant failed to meet her onus of proving entitlement to the claimed benefits.

The insurer was awarded $1,500 in expenses.

The applicant applied for statutory accident benefits following a motor vehicle accident.

His representative brought a motion to be removed from the record, and the insurer brought a motion to dismiss the arbitration due to the applicant's failure to participate.

The applicant did not attend the hearing despite receiving notice.

The arbitrator granted the representative's motion to withdraw and dismissed the arbitration due to the applicant's lack of interest and failure to present evidence.

The applicant was injured in a motor vehicle accident on October 29, 2010, and claimed statutory accident benefits.

The insurer reinstated her Income Replacement Benefits shortly before the arbitration hearing but disputed the need for an ongoing order and the applicable interest rate on overdue payments.

The arbitrator ordered ongoing IRBs at $400 per week.

On the issue of interest, the arbitrator held that because the accident occurred after September 1, 2010, the New Schedule applied, limiting the interest rate on overdue payments to 1 percent per month, despite the applicant holding a transitional policy.

The applicant applied for statutory accident benefits following a motor vehicle accident.

The applicant failed to attend the scheduled arbitration hearing.

At the commencement of the hearing, the applicant's representative brought an uncontested motion to be removed as the solicitor of record due to a breakdown in the solicitor-client relationship.

The arbitrator granted the motion to remove the representative.

As the applicant did not appear and presented no evidence to support his claims, the application for arbitration was dismissed.

The insurer was awarded $1,500 in expenses.

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

After the applicant's representative withdrew as counsel of record due to an inability to locate the applicant, the insurer requested a dismissal of the arbitration application without a hearing.

The arbitrator dismissed the arbitration due to the applicant's non-participation and ordered the applicant to pay the insurer's expenses in the amount of $2,983.97.

The arbitrator declined to award the insurer the return of its $3,000.00 assessment fee because there was insufficient evidence that the applicant failed to submit to an insurer examination or provide required materials.

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

Disputes arose and the applicant applied for arbitration.

The applicant failed to attend the pre-hearing and the arbitration hearing.

The applicant's counsel brought a motion to be removed from the record due to a breakdown in the solicitor-client relationship.

The arbitrator granted the motion to remove the representative and dismissed the application for arbitration due to the applicant's failure to attend and present evidence.

The applicant applied for statutory accident benefits following a motor vehicle accident.

After mediation failed, she applied for arbitration but failed to participate in the process, including a pre-hearing discussion.

The arbitrator scheduled a motion to dismiss the proceeding.

The applicant did not attend the motion despite receiving proper notice and phone calls from the arbitrator.

Consequently, the application for arbitration was dismissed.

The applicant applied for statutory accident benefits following a motor vehicle accident.

The matter proceeded to arbitration, but the applicant and his representative failed to appear at the hearing despite proper notice.

The arbitrator dismissed the application for arbitration due to the applicant's failure to present evidence to support his claims.

The insurer was awarded $1,500 in expenses for its preparation and attendance.

The applicant's representative brought a motion to be removed from the record due to a breakdown in the solicitor-client relationship, having lost contact with the applicant.

The insurer opposed the motion without terms, seeking its costs of $4,900 to be paid personally by the representative firm and requesting the arbitration be deemed withdrawn.

The arbitrator granted the representative's motion to withdraw, finding a fundamental breakdown in communication.

The arbitrator declined to order costs against the representative personally, finding the representative had authority to commence the proceeding to preserve the applicant's rights and was acting in the usual course of the practice of law under s. 282(11.3) of the Insurance Act.

The arbitrator also declined to deem the arbitration withdrawn, as the applicant did not have proper notice of that request.

The applicant applied for statutory accident benefits following a motor vehicle accident.

After failing to resolve the dispute at mediation, the applicant applied for arbitration but subsequently failed to participate in the process or attend the hearing.

The applicant's counsel brought a motion to be removed as representative of record, which was granted due to a breakdown in the solicitor-client relationship.

As the applicant did not appear and presented no evidence to support the claims, the application for arbitration was dismissed.

The insurer was awarded $750 in expenses.

The applicants sought statutory accident benefits following a motor vehicle accident but failed to attend their scheduled arbitration hearings despite receiving proper notice.

The arbitrator proceeded in their absence pursuant to the Statutory Powers and Procedures Act and the Dispute Resolution Practice Code.

The applications for arbitration were dismissed because the applicants failed to present evidence to prove their claims.

The insurer was awarded expenses fixed at $3,000 total, divided equally among the three applicants.