Donald Hale

The applicant was injured in a motor vehicle accident while riding her bicycle and sought statutory accident benefits.

The insurer terminated her income replacement and medical/rehabilitation benefits based on designated assessment centre (DAC) reports.

The arbitrator found that the applicant suffered a substantial inability to perform the essential tasks of her employment as a house cleaner due to chronic pain, entitling her to income replacement benefits up to the two-year anniversary of the accident.

The arbitrator also awarded medical benefits for prescription medications and transportation expenses, but denied claims for chiropractic care and injections as they were not reasonable or necessary.

The claim for hydrotherapy was deemed premature.

The arbitrator declined to make a special award, finding the insurer's reliance on the DAC reports was not unreasonable.

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

The parties attended mediation and executed a Release and Indemnity Agreement.

The insurer argued the agreement precluded the applicant from proceeding to arbitration for certain medical and rehabilitation benefits.

The arbitrator found the agreement ambiguous and admitted extrinsic evidence under an exception to the parol evidence rule.

The arbitrator concluded the parties intended to exclude the disputed clinic accounts from the release, allowing the applicant to proceed to arbitration.

The insurer brought a motion to determine whether the applicant was reasonably entitled to refuse to attend a psychiatric examination unless accompanied by her husband or mother.

The applicant argued she was emotionally fragile and required moral support based on past negative experiences.

The arbitrator applied the reasonableness test and found no evidence of bias or privacy concerns that would justify the condition.

The arbitrator concluded it was not reasonable for the applicant to refuse to submit to the examination unless accompanied, noting that an adverse inference could be drawn if she refused to attend alone.

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

The insurer terminated benefits, arguing she was no longer substantially unable to perform the essential tasks of her employment and lacked motivation to return to work.

The arbitrator found that the applicant suffered from post-traumatic stress disorder, depression, anxiety, and chronic pain as a result of the accident.

Based on medical and psychological evidence, the arbitrator concluded that the applicant's physical and psychological limitations continuously prevented her from engaging in any suitable occupation or employment.

The applicant was awarded ongoing weekly income benefits and interest.

The applicant was struck by a vehicle and sustained serious injuries, including a fractured pelvis.

She applied for statutory accident benefits for acupuncture, housekeeping, transportation, and a treadmill.

The insurer terminated payments for these benefits.

The arbitrator found that the acupuncture treatments provided necessary pain relief and that the applicant required ongoing housekeeping and transportation assistance due to her physical limitations.

The claims for acupuncture, housekeeping, and transportation were granted, while the claim for a treadmill was dismissed due to insufficient evidence.

The arbitrator declined to make a special award, finding the insurer's conduct was not unreasonable.

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

The applicant failed to attend the arbitration hearing, and the arbitrator proceeded in his absence.

Based on the uncontroverted evidence from the insurer, including medical assessments indicating the applicant sustained no injuries and was exaggerating symptoms, and evidence that the applicant was working as a construction labourer while receiving income replacement benefits, the arbitrator dismissed the claims for ongoing benefits.

The arbitrator ordered the applicant to repay $1,897.86 in benefits previously paid due to wilful misrepresentation.

The insurer was awarded $500 in expenses, but its request for repayment of the assessment fee under section 282(11.2) of the Insurance Act was denied as the proceeding was not found to be frivolous, vexatious, or an abuse of process.

The applicant, who suffered paraplegia in a motor vehicle accident, applied for statutory accident benefits.

The arbitrator found that the applicant was entitled to weekly income benefits post-156 weeks because her injuries continuously prevented her from engaging in substantially all of her pre-accident activities.

The arbitrator also awarded care benefits of $250 per week, finding that her husband reasonably lost this gross income in caring for her.

Claims for a new wheelchair, shower modifications, and counselling were granted as reasonable and necessary rehabilitation expenses, while claims for a new home, a modified van, and a power scooter were denied.

The applicant's request for a special award was dismissed as the insurer's conduct was not found to be unreasonable.

The applicant was injured in a motor vehicle accident and received weekly income benefits until the insurer terminated them on June 30, 1994.

The applicant applied for mediation in 1996 and subsequently for arbitration in November 1997.

The insurer raised a preliminary issue that the arbitration application was statute-barred under section 281(5) of the Insurance Act.

The arbitrator found that the two-year limitation period began running on June 30, 1994, and was extended for 90 days following the mediator's report on September 23, 1996.

As the application was filed nearly 11 months after the extended limitation period expired, the claim for weekly income benefits was statute-barred.