Eban Bayefsky

The Applicant was injured in a motor vehicle accident and applied for other disability benefits from her insurer.

The insurer denied the claim.

The Arbitrator found that the Applicant failed to submit her application within the 90-day time limit and did not have a reasonable excuse for the delay.

Furthermore, the Arbitrator held that the Applicant was not substantively entitled to other disability benefits, as her pre-existing severe disability from fibromyalgia meant she did not suffer a partial or complete inability to carry on a normal life as a result of the accident.

The application was dismissed.

The applicant's daughter was fatally injured in a motor vehicle accident.

The applicant, who resides in Vietnam, applied for death benefits from the insurer, claiming she was principally dependent for financial support on her daughter.

The insurer denied the claim.

The arbitrator found that the applicant failed to establish the requisite degree of financial dependence, as she provided insufficient and inconsistent evidence regarding her sources of income, the amount of support received from her daughter versus her other children, and her monthly expenses.

The claim for death benefits was dismissed.

Following a preliminary issue hearing where the insurer was successful in establishing that the applicant was not catastrophically impaired, the arbitrator determined the issue of arbitration expenses.

The arbitrator awarded the applicant 20% of his expenses, noting that while the insurer was successful on the principal issue, the applicant succeeded on secondary issues and the insurer failed to meaningfully participate in settlement discussions.

The applicant was awarded $3,047.89 in expenses.

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

After failing to respond to numerous communications from the Commission and failing to attend the pre-hearing conference, the arbitrator issued a notice of intent to dismiss the arbitration.

The applicant did not respond or object to the notice.

The arbitrator dismissed the arbitration without a hearing, finding it to be frivolous and abandoned, and awarded reasonable expenses to the insurer.

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

After the applicant's representative's law practice was taken over by the Law Society, the Commission made multiple unsuccessful attempts to contact the applicant.

The applicant failed to attend two scheduled pre-hearing conferences.

The insurer requested a dismissal of the arbitration.

The Arbitrator issued a notice of intention to dismiss the arbitration without a hearing on the grounds that the proceeding is frivolous, vexatious, or commenced in bad faith, giving the parties 20 days to object.

Following a preliminary issue hearing where the applicant was precluded from proceeding to arbitration on attendant care benefits, the insurer sought its expenses.

On consent of the parties, the arbitrator ordered the applicant to pay the insurer's expenses in the amount of $5,000, payable in equal monthly instalments over six months.

If the applicant defaults, the insurer may request an order for the balance of the expenses originally sought.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, claiming he was catastrophically impaired due to severe cervical spondolytic myelopathy causing quadriparesis.

The insurer denied the claim.

The arbitrator found that while the applicant suffered from a catastrophic impairment, it was not caused or materially contributed to by the motor vehicle accident.

The evidence demonstrated that the applicant's neurological decline was a result of the natural progression of his pre-existing degenerative condition, as his symptoms did not abruptly worsen immediately following the accident.

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

The insurer suspended benefits after the applicant failed to attend scheduled insurer medical examinations (IMEs) and a Designated Assessment Centre (DAC) assessment, as she had travelled out of the country.

On a preliminary issue hearing, the arbitrator found that the applicant failed to make herself reasonably available for the assessments.

However, because the insurer's notices for the IMEs were defective regarding the income replacement benefits claim, and because the housekeeping and attendant care claims pre-dated the non-compliance period, the arbitrator ruled that the applicant's arbitration could proceed as currently constituted.

The applicant, who was rendered a paraplegic in a 1994 motor vehicle accident, sought to arbitrate his entitlement to attendant care benefits.

The insurer argued that a 1996 settlement agreement precluded arbitration until the applicant moved into permanent housing accommodation and underwent a further Designated Assessment Centre (DAC) assessment.

The arbitrator found that the applicant's fluctuating living arrangements, which included living in a van and a recreational vehicle while pursuing a competitive sailing career, did not constitute permanent housing accommodation.

The arbitrator held that the applicant was bound by the procedural terms of the settlement and was precluded from proceeding to arbitration until he complied with the agreed-upon assessment process.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs) and medical benefits for prescription medication and travel expenses.

The insurer terminated IRBs on the basis that the applicant was not disabled from his pre-accident employment.

The arbitrator found that the accident significantly aggravated the applicant's pre-existing neck pain and materially contributed to his inability to return to work.

The applicant was awarded IRBs up to the 104-week mark, but failed to prove a complete inability to engage in any suitable employment beyond that period.

The claims for prescription medication and travel expenses were dismissed for lack of evidence connecting them to the accident.

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

Following an initial arbitration decision that determined the applicant's residual earning capacity was zero, the parties disagreed on the calculation of amounts owing.

The arbitrator held that the insurer must pay interest on the loss of earning capacity benefits from the two-year mark, as the benefits were overdue.

Furthermore, the tax paid on the applicant's long-term disability benefits must be calculated based on his total post-accident income for the purpose of collateral benefit deductions.

The arbitrator also found that employer pension contributions are not taxable when calculating net weekly income, and that post-accident employee benefits are not deductible collateral benefits.

The applicant was injured in a motor vehicle accident and commenced a civil action against the at-fault driver and the insurer for various damages and benefits.

She subsequently applied for arbitration at the Financial Services Commission of Ontario for supplementary medical, rehabilitation, and care benefits.

The insurer brought a motion to stay the arbitration on the basis of the related and more comprehensive tort action.

The Arbitrator applied the test for multiple proceedings and found that the arbitration involved substantially similar issues, would require overlapping evidence, and could lead to inconsistent results.

The arbitration was stayed pending the amendment of the Statement of Claim in the civil action and the outcome of the court proceeding.

The insurer brought a motion to dismiss the applicant's arbitration for statutory accident benefits and sought costs against the applicant's representative personally, following the representative's failure to comply with conditions attached to a previously granted adjournment.

The arbitrator declined to dismiss the arbitration, finding that the applicant was not responsible for the representative's conduct and the proceeding was not frivolous or vexatious.

However, the arbitrator found that the representative failed without reasonable explanation to comply with the adjournment conditions and caused the insurer to incur expenses without reasonable cause.

The representative was ordered to personally pay $500 in costs to the insurer.

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

The insurer denied the claim and argued at a preliminary issue hearing that the applicant was disentitled to benefits under section 48(1) of the Statutory Accident Benefits Schedule because he wilfully misrepresented the circumstances of the accident.

The insurer relied on an accident reconstruction expert who concluded the vehicle damage was inconsistent with the applicant's statements.

The arbitrator found the expert's analysis contained numerous weaknesses, including reliance on an unreliable speed estimate and photographs taken after a subsequent accident.

The arbitrator concluded the insurer failed to discharge its onus of proving wilful misrepresentation and held the applicant was not disentitled to benefits.

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

The insurer denied benefits, alleging the applicant failed to submit an application within 30 days of receiving the forms, as required by section 32(3) of the Statutory Accident Benefits Schedule.

On a preliminary issue hearing, the arbitrator found that the applicant had provided sufficient information to the insurer within the 30-day period to allow it to commence adjusting the claim, even if not on the insurer's specific forms.

Furthermore, the insurer failed to properly inform the applicant of the consequences of non-compliance.

The applicant was permitted to proceed to arbitration.

Following an arbitration regarding statutory accident benefits, the parties sought their expenses.

Although the insurer was largely successful on the substantive issues, the arbitrator found that the insured was justified in proceeding to a hearing because the insurer had only conceded general entitlement prior to the hearing and the insured was successful in obtaining a special award.

The arbitrator ordered the insurer to pay 80% of the insured's arbitration expenses, amounting to $4,100.22.

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

The insurer denied benefits and raised the preliminary issue of wilful misrepresentation.

The applicant objected to the late service of the insurer's expert reports and argued the insurer failed to provide proper notice of the reasons for denying benefits.

The arbitrator allowed the late expert reports, finding no procedural unfairness or prejudice to the applicant.

The arbitrator also held that the insurer provided sufficient notice of its wilful misrepresentation defence in its Response to the Application for Arbitration, allowing the preliminary issue hearing to proceed.

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

Following an initial arbitration and subsequent appeal that remitted the matter for a new hearing, the insurer sought production of independent medical examinations (IEs) obtained in the applicant's related tort action.

The arbitrator considered the recent Court of Appeal decision in Tanner and the tribunal's approach to importing documents from civil actions.

Finding that the insurer had a compelling reason for not obtaining its own updated medical assessments due to the intervening appeal, the arbitrator ordered the applicant to produce the tort IEs in her possession for the period between the first hearing and the appeal decision.

The insurer brought a motion to dismiss the applicant's arbitration for statutory accident benefits due to the applicant's repeated failure to comply with production and cost orders.

The arbitrator declined to dismiss the arbitration, finding that the specific notice prerequisites for dismissal without a hearing under Rule 68 of the Dispute Resolution Practice Code had not been met.

However, to prevent an abuse of process under Rule 65.7, the arbitrator stayed the arbitration pending the applicant's compliance with all previous orders and payment of $500 in costs for the motion.

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

Her paralegal representative negotiated a full and final settlement with the insurer.

The applicant later refused to sign the release, claiming she had not authorized the settlement amount.

The arbitrator found that the representative had ostensible authority to settle the claim and that a binding agreement was reached.

Because the applicant failed to rescind the settlement in writing within the two-day cooling-off period prescribed by the Settlement Regulation, she was bound by the settlement and precluded from proceeding with her arbitration.