Isoken Osunde

The applicant was injured in a motor vehicle accident and sought enhanced statutory accident benefits, claiming she suffered a catastrophic impairment.

The arbitrator found that the applicant sustained a catastrophic impairment under section 2(1.2)(g) of the Schedule, as she suffered a marked impairment in the area of adaptation due to a major depressive disorder.

The arbitrator preferred the evidence of the applicant's psychological expert over the insurer's expert, noting the former's comprehensive review of medical records and adherence to the AMA Guides.

The applicant was awarded ongoing income replacement benefits, having established a complete inability to engage in suitable employment due to chronic pain and medication side effects.

The arbitrator also awarded housekeeping benefits, specific periods of attendant care benefits, and approved several treatment plans.

A special award of 20% was ordered against the insurer for unreasonably delaying the assessment and payment of pre-104 week attendant care benefits following the applicant's surgery.

The applicant was involved in two motor vehicle accidents (2005 and 2007).

He sought statutory accident benefits from the insurer for the 2007 accident, claiming it exacerbated his cognitive and executive function impairments from the 2005 accident.

The insurer argued the impairments were solely from the 2005 accident.

Applying the material contribution test, the arbitrator found the 2007 accident materially contributed to the applicant's worsening cognitive impairments.

The arbitrator approved treatment plans for occupational therapy, speech therapy, rehab coaching, and a catastrophic assessment, but denied duplicate occupational therapy and case management services (as catastrophic impairment was not yet determined).

A special award was denied, but interest on overdue payments was granted.

The applicant sought statutory accident benefits after suffering a catastrophic impairment from a fall.

The insurer denied the claim, arguing the fall did not involve the use or operation of an automobile.

At a preliminary issue hearing, the applicant claimed he fell while exiting his vehicle when the passenger door blew back in the wind.

The arbitrator reviewed conflicting documentary evidence, including ambulance and hospital records, and a 911 call, none of which mentioned a vehicle.

The arbitrator rejected the applicant's version of events, finding the fall did not involve an automobile, and concluded the applicant was not injured in an 'accident' under section 3(1) of the Statutory Accident Benefits Schedule.

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

After a settlement was reached, the applicant failed to sign the settlement documents and became unreachable.

The insurer requested a resumption of the pre-hearing discussion to dismiss the application.

The applicant's counsel moved to be removed from the record due to a breakdown in the solicitor-client relationship.

The applicant failed to attend the hearing.

The arbitrator granted the counsel's motion to withdraw, dismissed the application for arbitration due to the applicant's failure to discharge his onus, and ordered the applicant to pay the insurer's expenses of $2,573.13.

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

A dispute arose and the applicant applied for arbitration.

The applicant failed to participate in the pre-hearing and did not appear at the arbitration hearing.

The applicant's representative brought a motion to be removed from the record, which was granted.

The arbitrator dismissed the application for arbitration due to the applicant's failure to participate and tender evidence.

The insurer was awarded $250 in expenses.

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

A dispute arose and the applicant applied for arbitration.

The applicant's representative brought a motion to be removed from the record, which was granted after the applicant failed to attend the hearing.

As the applicant did not attend the proceedings or present any evidence to support his claim, he failed to discharge his onus of proving entitlement to the benefits claimed.

The application for arbitration was dismissed, and the applicant was ordered to pay $500 in expenses to the insurer.

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

After a breakdown in the solicitor-client relationship, the applicant's counsel was removed from the record.

The applicant failed to attend the scheduled arbitration hearing despite being advised of the consequences.

As the applicant bore the onus of proving entitlement and failed to produce any evidence, the application for arbitration was dismissed.

The insurer was awarded $500 in expenses.

The applicant sought expenses following an arbitration decision where she was partially successful in claiming housekeeping and home maintenance benefits.

The applicant claimed $15,537.50 in legal fees and $2,722.00 in disbursements.

The insurer argued each party should bear its own expenses.

The arbitrator considered the degree of success, settlement offers, and conduct during the proceeding under Rule 75 of the Dispute Resolution Practice Code.

Finding the applicant partially successful and the case not complex, the arbitrator awarded $3,000.00 for fees and $2,722.00 for disbursements, totaling $5,722.00.

The applicant was injured in a motor vehicle accident while riding as a passenger on a city bus.

She applied for a determination of catastrophic impairment, which the insurer denied.

At arbitration, the arbitrator considered whether the applicant met the criteria under sections 2(1.2)(f) and (g) of the Statutory Accident Benefits Schedule.

The arbitrator found that the applicant's combined physical and psychological impairments resulted in a 42% whole person impairment, falling short of the 55% threshold under section 2(1.2)(f).

However, the arbitrator concluded that the applicant suffers from a pain disorder driven by both physical and psychological factors, resulting in a marked impairment in the realm of adaptation.

Consequently, the applicant was deemed catastrophically impaired under section 2(1.2)(g).

The applicant's request for a special award was denied as there was no dispute regarding the payment of benefits.

The insurer brought a motion to compel the applicant to produce her cell phone records for the date of the motor vehicle accident.

The insurer argued the records were necessary to locate a witness to clarify discrepancies regarding the circumstances of the accident.

The arbitrator dismissed the motion, finding that the insurer did not dispute that the accident occurred and made no allegation of fraud.

The cell phone records were deemed not relevant to the substantive issues in dispute, and their probative value did not outweigh the applicant's reasonable expectation of privacy.

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

The matter proceeded to an arbitration hearing, but the applicant failed to attend.

At the hearing, the applicant's representative brought an unopposed motion to be removed from the record, which was granted.

Due to the applicant's failure to attend and prove her claim, the arbitrator dismissed the application for arbitration.

No order was made regarding expenses, though the arbitrator remained seized of the issue.

The applicant was injured when she fell inside a public transit bus due to sudden acceleration.

She applied for statutory accident benefits, claiming housekeeping and home maintenance benefits as well as the cost of custom orthotics, which the insurer denied.

The arbitrator found the applicant's testimony regarding her symptoms credible and supported by objective medical evidence, including an MRI showing a tear in her right wrist and an ankle effusion.

The arbitrator rejected the insurer's medical assessments, noting they failed to consider the MRI results.

The applicant was awarded housekeeping benefits at $100 per week for the initial period and $50 per week thereafter, along with the cost of the custom orthotics and interest on overdue payments.

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

After failing to attend a pre-hearing discussion, the matter was scheduled for an arbitration hearing.

The applicant failed to attend the arbitration hearing despite receiving notice.

The arbitrator dismissed the application for arbitration due to the applicant's failure to participate and tender evidence.

No order was made regarding expenses, but the arbitrator remained seized of the issue.

The applicant sought statutory accident benefits following the death of her husband in a motor vehicle accident in Somaliland, Africa.

The insurer denied the claim on the basis that the accident occurred outside the territorial limits set out in the Statutory Accident Benefits Schedule.

The applicant argued the legislation was ambiguous regarding accidents outside Canada and the United States and that contra proferentem should apply.

The arbitrator found no ambiguity in the legislation, concluding that the legislature intentionally restricted benefits to accidents occurring in Canada or the United States.

The applicant was therefore precluded from claiming benefits.

The insurer brought a motion to dismiss the applicant's arbitration application for statutory accident benefits after the applicant failed to participate following an order for a rehearing.

The arbitrator declined to dismiss the application as frivolous or vexatious, noting that such a finding requires an assessment of the merits.

However, given the applicant's failure to retain new counsel, attend the motion, or respond to communications, the arbitrator deemed the application constructively withdrawn pursuant to Rule 70 of the Dispute Resolution Practice Code.

No expenses were awarded to the insurer.