Dirk C. VanderBent

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

The applicant applied for arbitration.

The insurer brought a preliminary motion to adjourn the arbitration until the applicant attended independent medical examinations by an orthopaedic surgeon and a neurologist.

The arbitrator found that the requested examinations were reasonably required under section 23(2) of the Statutory Accident Benefits Schedule, given a recent head injury diagnosis and the length of time since the last orthopaedic assessment.

The motion was granted and the arbitration was adjourned.

The applicant was injured in a motor vehicle accident and received weekly income benefits before returning to work.

The insurer terminated benefits and argued the applicant was barred from further benefits under subsection 16(2) of the Statutory Accident Benefits Schedule because she worked for more than 90 days.

The arbitrator held that subsection 16(2) does not bar an insured from receiving further benefits, but only affects the evidentiary presumption of ongoing eligibility.

The arbitrator also determined that the disability entitlement test under subsection 12(5) refers to 156 weeks of disability, and that post-accident employment income does not delay or interrupt the running of this period.

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

The insurer denied weekly income benefits on the basis that the applicant was not authorized by law to drive at the time of the accident.

The applicant's driver's license had expired over a decade prior and was also suspended for unpaid fines.

The arbitrator held that the applicant was ineligible for benefits under section 58(1)(d) of the Statutory Accident Benefits Schedule.

The exception in section 58(2) for suspensions due to unpaid fines did not apply because the applicant's license had also expired and he would have had to requalify as a new driver.