Fern Kirsch

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

She applied for arbitration claiming ongoing weekly income benefits, medical expenses, and a special award.

The arbitrator found that the applicant suffered a substantial inability to perform the essential tasks of her employment as a dispatcher/cashier due to ongoing physical and psychological injuries, including right arm weakness, anxiety, and depression caused by the accident.

The arbitrator awarded weekly income benefits for the disputed two-year period.

Claims for nutritional counselling, meal replacements, and a special award were dismissed due to insufficient evidence.

The arbitrator also ruled that the new expense provisions under the Automobile Insurance Rate Stability Act did not apply retroactively, denying the insurer's claim for expenses and awarding the applicant her expenses of the proceeding.

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

The insurer alleged that the applicant's request for arbitration was out of time.

The arbitrator found that the insurer's notices of refusal to pay benefits were not clear and unequivocal, lacked sufficient reasons, and were not properly communicated to the applicant.

Therefore, the limitation period did not begin to run, and the applicant's arbitration proceeding was commenced in time.

The applicants were injured in a motor vehicle accident and claimed statutory accident benefits from the insurer, including income replacement benefits, caregiver benefits, and taxi expenses.

The arbitrator found that the insurer was liable to pay benefits as there was no other available insurance.

However, the arbitrator dismissed the claims for income replacement benefits, finding that neither applicant had a legitimate contract of employment evidenced in writing at the time of the accident, and the female applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident self-employment.

The claims for caregiver benefits and taxi expenses were also dismissed due to a lack of objective medical evidence and failure to prove the expenses were reasonably incurred.

The applicants were awarded one-third of their arbitration expenses.

The applicant was injured in a motor vehicle accident and received weekly income benefits until May 8, 1994.

He sought reinstatement of benefits until November 1, 1994, claiming he was substantially unable to perform his essential tasks as a ditch digger due to a knee injury.

The arbitrator found that the applicant had largely recovered by January 1994 and failed to prove he was substantially unable to perform his essential tasks during the disputed period.

The claims for weekly income benefits and a special award were dismissed.

The insurer's claim for repayment of post-accident income was also dismissed.

The applicant, a 62-year-old labourer with a grade three education, was struck by a motor vehicle and suffered multiple injuries, including fractured ribs and a head injury.

He applied for ongoing weekly income benefits under section 12(5)(b) of the Statutory Accident Benefits Schedule after the insurer terminated them.

The arbitrator found that the applicant suffered from post-concussion syndrome and chronic disabling pain resulting from the accident.

Given his age, limited education, poor English skills, and physical limitations, the arbitrator concluded that the applicant was continuously prevented from engaging in any suitable occupation or employment.

The insurer was ordered to pay weekly income benefits of $536.75 from May 5, 1994 onwards, plus interest and expenses.

The applicant was injured in a motor vehicle accident and received weekly income benefits for 156 weeks.

He applied for continued benefits under section 12(5)(b) of the Statutory Accident Benefits Schedule, claiming his physical and psychological injuries continuously prevented him from engaging in any suitable employment.

The arbitrator found that the applicant failed to prove his physical injuries prevented him from engaging in suitable employment other than his pre-accident work as a drywaller.

The arbitrator also found insufficient evidence linking the applicant's depression to the accident.

The claims for continued income benefits and a special award were dismissed, but the applicant was awarded expenses.

The applicant was injured in a motor vehicle accident and received weekly income benefits from the insurer.

The insurer terminated benefits, arguing the applicant was capable of working and that his disability was caused by his bankruptcy rather than the accident.

The arbitrator found that the applicant suffered from chronic pain syndrome caused by the accident, which continuously prevented him from engaging in any occupation for which he was reasonably suited by education, training, or experience.

The arbitrator also found that the parties had previously settled the quantum of benefits at $600 per week.

The insurer's claim for repayment was dismissed.

A special award of $600 was granted because the insurer unreasonably withheld benefits by failing to provide proper notice of its reasons for termination.

The applicant was injured in a motor vehicle accident and sought a determination of the quantum of his weekly income benefits.

The arbitrator had to decide whether to calculate the applicant's pre-accident income by averaging his earnings over the 22 weeks he actually worked, or over the full 52 weeks preceding the accident.

Following previous tribunal decisions, the arbitrator held that the plain language of the Statutory Accident Benefits Schedule required averaging the income over 52 weeks, resulting in a weekly benefit of $250.22.

The arbitrator denied the applicant's request for a special award for unreasonably withheld benefits, noting that the delay was partly attributable to the applicant's refusal to include the quantum issue in the initial hearing.

The insurer's request for costs was denied, and the applicant was awarded his expenses for the arbitration.

The Arbitrator issued a correction to a previous decision dated June 24, 1996.

The correction amended the interest rate awarded to the applicant from 2% per annum to 2% per month on any outstanding amounts.

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

She applied for ongoing weekly income benefits, arguing she suffered from post-concussion syndrome and a brain injury that prevented her from working.

The insurer argued her inability to work was due to pre-existing psychological conditions and post-accident life events.

The arbitrator found that the accident materially contributed to her disability, exacerbating a pre-existing personality disorder, and that she was continuously prevented from engaging in suitable employment.

The arbitrator also ordered a $5,000 special award against the insurer for unreasonably terminating and withholding benefits based on a cursory neurological report while ignoring numerous other medical recommendations.

The applicant, a taxi driver, was injured in a motor vehicle accident and received weekly income benefits until January 1994.

He applied for reinstatement of benefits, claiming ongoing physical and psychological injuries rendered him substantially unable to perform his essential tasks.

The arbitrator found the applicant's evidence contradictory and unsupported by the medical reports, which largely recommended a return to work.

The claims for ongoing weekly income benefits and a special award were dismissed, though the applicant was awarded his arbitration expenses.

The applicant sought an assessment of expenses following an arbitration order granting him his expenses.

The insurer argued that payment should be delayed pending an appeal and that the legal fees claimed were unreasonable.

The arbitrator held that the original order remained in full force and effect because the insurer had not requested a stay pending appeal.

The arbitrator also found that the 50.75 hours of legal work claimed by the applicant's counsel were reasonable given the complexity of the case and the duration of the hearing.

The insurer was ordered to pay the expenses forthwith.

The Arbitrator issued a correction to a previous decision dated February 9, 1996.

The correction amended the date from which the applicant is entitled to receive interest on outstanding amounts under section 24 of the Statutory Accident Benefits Schedule.

The date was changed from June 8, 1994, to September 2, 1993, reflecting that the relevant document was deemed received by the insurer on August 3, 1993.

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

A dispute arose regarding the calculation of his pre-accident gross weekly income as a self-employed ceramic tile setter, as he had poor business records.

The arbitrator accepted reconstructed invoices as reliable evidence of his actual earnings.

The arbitrator calculated the applicant's gross weekly income and awarded a weekly income benefit of $550.52.

The arbitrator also held that the application for benefits was 'completed' when it was filled in, signed, and provided to the insurer, entitling the applicant to interest on overdue payments from 30 days after that date.

The insurer sought an order requiring the insured to attend an independent medical examination in London and a functional capacities evaluation at the Canadian Back Institute.

The arbitrator held that the insurer could choose its medical examiner, but it was unreasonable to require the insured to travel from Windsor to London for the examination.

The arbitrator also dismissed the request for a functional capacities evaluation, finding no evidence that the chosen doctor required an assessment by an undesignated health professional to assist in evaluating the insured's condition.

The Applicant was injured in a motor vehicle accident and claimed statutory accident benefits.

The parties attended mediation and signed a settlement agreement for $16,900.

The Applicant later sought to arbitrate the claims, arguing he was confused during mediation and that the Insurer failed to pay outstanding physiotherapy expenses.

The Arbitrator found that the Applicant understood the settlement, signed a release, and failed to rescind it within the two-day cooling-off period.

The preliminary issue was resolved in favour of the Insurer, barring the Applicant from proceeding to arbitration.

The Applicant's request for expenses was denied as the application was deemed frivolous.

The applicant was injured in a motor vehicle accident and received weekly income benefits from the insurer until they were terminated.

The applicant sought reinstatement of benefits, arguing he was either on a temporary lay-off or employed for 180 days in the twelve months preceding the accident.

The insurer argued the applicant did not qualify and sought repayment of benefits previously paid, alleging the applicant misrepresented his employment status.

The arbitrator found that the applicant retained his employment status while receiving workers' compensation benefits, thus satisfying the 180-day employment requirement.

The arbitrator also found the applicant did not knowingly misrepresent his status, dismissing the insurer's claim for repayment.

The applicant was awarded reinstatement of weekly income benefits and arbitration expenses.