Eban Bayefsky

The applicant was involved in three motor vehicle accidents in 2010 and 2011 and sought statutory accident benefits from the insurer, including income replacement benefits and medical benefits for various chiropractic and physiotherapy treatment plans.

The insurer denied the claims, arguing that the applicant did not suffer a substantial inability to perform the essential tasks of his employment and that his injuries fell within the Minor Injury Guideline.

The arbitrator dismissed the applicant's claims, finding that he provided virtually no evidence regarding his pre-accident employment or the extent of his injuries.

The arbitrator relied on the insurer's medical assessments, which concluded that the applicant's injuries were minor and did not warrant treatment outside the Minor Injury Guideline.

The insurer was awarded $4,000 in arbitration expenses.

The applicant sought statutory accident benefits for chiropractic treatment plans and in-home assessments following a 2012 motor vehicle accident.

The insurer denied the claims based on its medical assessments indicating the injuries were minor and required no further treatment.

The arbitrator dismissed the application in its entirety, finding the applicant completely lacking in credibility due to numerous inconsistencies, evasions, and denials regarding his significant pre-accident medical history.

The arbitrator concluded that the applicant's lack of credibility fundamentally undermined the reliability of his treating practitioners' recommendations, and the applicant failed to establish that the claimed benefits were reasonable and necessary.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for caregiving, housekeeping, attendant care, and medical expenses, as well as a special award.

The arbitrator found that the applicant failed to establish on a balance of probabilities that she suffered a substantial inability to perform her pre-accident caregiving and housekeeping tasks, or that she required the claimed attendant care assistance.

The arbitrator noted inconsistencies in the applicant's evidence, her failure to disclose her ongoing receipt of ODSP benefits to medical assessors, and preferred the evidence of the insurer's occupational therapist who found the applicant could perform her activities of daily living with assistive devices.

All claims for benefits, interest, and a special award were dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the insurer, claiming he sustained a catastrophic impairment due to severe psychological and physical injuries.

The insurer denied the claims, arguing the applicant was malingering and not significantly disabled.

The arbitrator found the applicant credible and concluded he suffered a catastrophic impairment under s. 2(1.2)(g) of the Schedule, experiencing marked impairment in activities of daily living and concentration, persistence, and pace.

The arbitrator awarded income replacement benefits, attendant care benefits at $6,000 per month, and an occupational therapy treatment plan.

Housekeeping benefits were denied due to insufficient evidence of the pre-accident baseline.

A special award of $5,000 was ordered against the insurer for unreasonably delaying payment for the applicant's psychiatric medications.

The applicant claimed statutory accident benefits following an alleged motor vehicle accident.

The insurer denied the claim on the basis that the accident was staged and therefore did not meet the definition of an 'accident' under section 2(1) of the Statutory Accident Benefits Schedule.

A preliminary issue hearing was scheduled to determine this issue.

Neither the applicant nor his representative attended the hearing.

Pursuant to Rule 37.7 of the Dispute Resolution Practice Code, the arbitrator proceeded in the applicant's absence.

Without any evidence from the applicant to prove an accident occurred, the arbitrator dismissed the arbitration and ordered the applicant to pay the insurer's expenses.

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

After a lengthy history of delays and adjournments, the applicant failed to attend the peremptory arbitration hearing, claiming illness at the last minute.

The arbitrator proceeded in his absence and dismissed the claims, finding the applicant failed to discharge his onus.

The insurer was awarded arbitration expenses due to the applicant's conduct, which prolonged the proceeding and constituted an abuse of process.

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

The applicant failed to attend the peremptory arbitration hearing, despite a recent denial of her adjournment request.

The arbitrator proceeded in her absence and dismissed the arbitration, finding the applicant failed to discharge her onus of establishing entitlement to the claimed medical benefits and examination expenses.

The insurer was awarded arbitration expenses due to the applicant's conduct, which prolonged the proceeding and amounted to an abuse of process.

Following a successful arbitration where the insurer prevailed on all issues, the insurer sought its expenses.

The arbitrator considered the criteria under Rule 75.2 of the Dispute Resolution Practice Code.

Finding that the insurer was fully successful, no settlement offers were exchanged, and the applicant caused some delay, the arbitrator awarded expenses to the insurer.

The requested legal fees were reduced as excessive given the brevity and simplicity of the hearing.

The applicant was ordered to pay the insurer $3,437.80 in arbitration expenses.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including non-earner, attendant care, housekeeping, and medical benefits, which the insurer denied.

The arbitrator found the applicant credible and concluded she suffered soft-tissue injuries that continuously prevented her from engaging in substantially all of her pre-accident activities, entitling her to non-earner benefits.

The arbitrator also awarded attendant care benefits for a limited period at a reduced rate, and housekeeping benefits for the claimed period, less a two-week vacation.

The insurer was ordered to pay for an approved treatment plan and two assessments, along with a special award for unreasonably withholding payment for the assessments, plus interest.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including non-earner, attendant care, housekeeping, and medical benefits.

The arbitrator found significant credibility issues with the applicant's evidence, noting inconsistencies and symptom magnification.

The claims for non-earner and housekeeping benefits were dismissed as the applicant failed to establish a complete or substantial inability to perform his pre-accident activities.

Attendant care benefits were granted for a limited one-month period.

The arbitrator also awarded the cost of an attendant care assessment, one treatment plan, and a special award due to the insurer's unreasonable delay in paying for the assessment.

The applicant sought attendant care and medical benefits following a motor vehicle accident.

The arbitrator dismissed the claims, finding that the applicant failed to provide sufficient evidence of significant injuries or a need for attendant care.

The applicant's own prior statements contradicted his claim for attendant care, and he failed to introduce a valid Form 1 or the disputed treatment plan into evidence.

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits, including income replacement benefits, housekeeping benefits, and the cost of a multidisciplinary assessment.

The insurer terminated income replacement and housekeeping benefits shortly after the accident.

The arbitrator found that the applicant suffered significant soft-tissue injuries that developed into chronic pain and fibromyalgia, rendering her substantially unable to perform her pre-accident physically demanding job as a product demonstrator, and completely unable to engage in alternative employment.

Income replacement benefits were reinstated.

However, the claim for housekeeping benefits was dismissed, as the evidence showed the applicant retained essential independence in her household tasks, albeit at a slower pace.

The arbitrator also approved the cost of the multidisciplinary assessment, finding it reasonable and necessary given the applicant's complex psycho-physical presentation, and awarded interest on overdue amounts.

The Applicant was catastrophically injured in a motor vehicle accident and previously awarded statutory accident benefits, including income replacement, attendant care, and nutritional counselling.

In this resumed hearing, the Arbitrator determined the Applicant's entitlement to interest on overdue benefits and a special award.

The Arbitrator found the Insurer liable for interest on all three benefit categories, noting the Insurer had sufficient information to adjust the claims early on despite procedural delays by the Applicant.

Furthermore, the Arbitrator ordered a special award of $750,000 against the Insurer under section 282(10) of the Insurance Act, finding the Insurer's conduct in handling the attendant care and nutritional counselling claims to be significantly blameworthy and in breach of its statutory obligations.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement, attendant care, and housekeeping benefits.

The insurer terminated these benefits based on independent medical assessments.

The arbitrator found that the applicant suffered a substantial inability to perform the essential tasks of his pre-accident employment as a chef and awarded income replacement benefits, subject to deduction for post-accident employment income.

However, the claims for attendant care and housekeeping benefits were dismissed, as the applicant failed to establish that he required the extent of assistance claimed.

The insurer brought a motion for an order declaring the applicant is not entitled to statutory accident benefits until she submits to an Examination Under Oath (EUO).

The applicant brought a cross-motion to preclude the insurer from examining her regarding income replacement and housekeeping benefits, arguing that because the insurer initially paid these benefits, it could not later require an EUO under section 35(3) of the Schedule.

The arbitrator held that section 35(3) does not restrict an insurer's ongoing right to request an EUO under section 33.

The applicant was found to have failed to attend the EUO by refusing to answer relevant questions.

The arbitration was adjourned sine die, benefits were suspended until attendance, and the applicant was ordered to pay $1,000 in expenses.

Following a decision denying the applicant's claims for statutory accident benefits, the parties sought a determination on their entitlement to arbitration expenses.

The arbitrator applied Rule 75.2 of the Dispute Resolution Practice Code, noting that the insurer was entirely successful in the arbitration and had made a more reasonable settlement offer.

The issues raised were not particularly novel.

Consequently, the arbitrator found the insurer entitled to its expenses and ordered the applicant to pay the agreed quantum of $11,974.72.

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

The insurer denied claims for attendant care, caregiver, and housekeeping benefits, arguing the applicant's injuries were minor and her presentation was not credible.

The arbitrator found that the applicant suffered significant psycho-emotional injuries, including chronic pain syndrome and post-traumatic stress disorder, resulting in a catastrophic impairment.

The arbitrator awarded attendant care benefits at the maximum rate of $6,000 per month, caregiver benefits for her younger son, and housekeeping benefits.

A claim for home modifications was denied as the renovations were planned prior to the accident.

The arbitrator also ordered a 10% special award against the insurer for unreasonably withholding payments without adequately assessing the medical evidence.

The insurer brought a motion to stay the arbitration pending the insured's attendance at further catastrophic impairment assessments.

The insured had initially claimed catastrophic impairment under Criterion 8 (mental or behavioural disorder), but later obtained reports indicating she also met Criterion 7 (55% whole person impairment).

The insurer sought to have her assessed under Criterion 7.

The arbitrator applied the six-part test for determining whether an insurer's request for an examination is reasonable and necessary.

Finding that the insurer would be prejudiced if not permitted to investigate the new claim, the arbitrator granted the motion and adjourned the hearing pending the insured's attendance at the requested assessments.

The applicant was injured in a motor vehicle accident and sought various statutory accident benefits from his insurer, including income replacement, attendant care, housekeeping, medical benefits, and the cost of examinations.

The insurer had terminated income replacement benefits on the basis of non-compliance with a work-hardening program.

The arbitrator found that the applicant had participated in the program and that his severe back injuries and chronic pain rendered him completely incapable of engaging in suitable alternative employment.

The arbitrator awarded ongoing income replacement benefits, partial attendant care and housekeeping benefits, the requested medical benefits and examinations, and interest.

Furthermore, the arbitrator ordered the insurer to pay a maximum special award of 50% for unreasonably withholding income replacement benefits after receiving evidence of the applicant's compliance with rehabilitation.

The applicant was injured in a motor vehicle accident when he was nine years old.

He applied for non-earner benefits upon turning 16, arguing that his accident-related impairments continuously prevented him from engaging in substantially all of his pre-accident activities, leading him to drop out of school.

The arbitrator found that the applicant's academic and social difficulties were not primarily caused by the accident, but rather by pre-existing learning issues, a more demanding high school curriculum, and non-accident-related back pain.

The application for non-earner benefits, along with claims for a special award and interest, was dismissed.