Jeff Musson

The applicant sought expenses following an arbitration decision regarding statutory accident benefits.

The insurer argued for a reduced amount or that each party bear their own expenses due to divided success.

The arbitrator found the applicant was more successful overall and entitled to expenses.

Applying the principle of fairness and legal aid rates, the arbitrator fixed the applicant's expenses at $54,250.27 inclusive of fees, disbursements, and HST.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including a determination of catastrophic impairment, attendant care, caregiver, medical, and housekeeping benefits.

The arbitrator found that the applicant failed to prove her entitlement on a balance of probabilities, noting significant issues with her credibility, evidence of malingering, and a failure to disclose pre-existing medical conditions.

The arbitrator preferred the evidence of the insurer's medical experts, who concluded that the applicant had reached maximum medical recovery and did not meet the threshold for catastrophic impairment.

All claims for benefits were denied.

The insurer, having been entirely successful in defending the applicant's claims for statutory accident benefits at arbitration, sought $11,529.41 in expenses.

The arbitrator noted that the applicant was self-represented and that the Statutory Accident Benefits Schedule is consumer protection legislation.

Applying the principle of fairness, the arbitrator fixed the insurer's expenses at $500.00 inclusive of fees, disbursements, and HST, to avoid financially penalizing the applicant for pursuing a legitimate dispute.

Following an arbitration where the applicant's claims for statutory accident benefits were dismissed, the insurer requested an expense hearing to determine the quantum of costs payable by the applicant.

The insurer claimed $12,714.78 in fees and disbursements.

The arbitrator considered the criteria under Rule 75.2 of the Dispute Resolution Practice Code, noting the insurer's 100% success and an unaccepted Rule 76 offer to settle.

Applying the principle of fairness and recognizing the consumer protection nature of the legislation, the arbitrator applied a 50% discount to the insurer's fees and disallowed certain disbursements.

The applicant was ordered to pay $5,634.95 in total expenses.

Following an arbitration where the insurer successfully defended all claims for statutory accident benefits, the insurer sought its expenses.

The arbitrator found that the applicant's conduct, including the late production of a voluminous ODSP file and changing the structure of the case mid-hearing, unnecessarily prolonged and hindered the proceedings.

Applying the principle of fairness and noting the consumer protection nature of the legislation, the arbitrator applied a 25% discount to the insurer's legal fees and excluded surveillance costs from disbursements.

The applicant was ordered to pay the insurer's expenses fixed at $52,167.11.

Following an arbitration where the insurer successfully defended all issues in dispute, the insurer requested an expense hearing.

The applicant failed to submit any materials or respond to the insurer's cost submissions.

The arbitrator found that the applicant's claim for income replacement benefits was improper and vexatious, as she was operating a business while claiming benefits.

The arbitrator awarded the insurer its full claimed expenses of $30,967.21, noting the amounts were within the maximum limits permitted under the Expense Regulation and billed at the Legal Aid rate.

The applicant sought expenses following a successful arbitration where she was found to be catastrophically impaired.

The applicant claimed $154,064.95 in fees and disbursements.

The insurer argued the fees and disbursements were unreasonable.

The arbitrator reviewed the criteria under the Dispute Resolution Practice Code, noting the applicant's 100% success and the insurer's conduct which prolonged the hearing.

The arbitrator reduced the legal fees to exclude work done prior to the application for arbitration and reduced several disbursement claims to align with allowed amounts.

The applicant's expenses were fixed at $135,568.78.

The Applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment, attendant care benefits, and medical benefits.

The Insurer denied the claims, arguing the Applicant's ongoing issues were related to pre-existing conditions and that he was malingering.

The Arbitrator found the Applicant and his family members lacked credibility, noting significant inconsistencies between their testimony, the Applicant's pre-accident medical history, his receipt of ODSP benefits, and surveillance evidence showing him performing normal daily activities.

The Arbitrator preferred the evidence of the Insurer's medical experts, who found the Applicant was malingering and that his impairments were not caused by the accident.

The claims for catastrophic impairment, attendant care benefits, and medical benefits were dismissed.

The self-represented applicant sought income replacement benefits (IRBs) following a motor vehicle accident.

The arbitrator found that the applicant failed to prove on a balance of probabilities that he suffered a substantial inability to perform the essential tasks of his pre-accident employment as a self-employed contractor.

The medical evidence submitted did not specifically address the essential tasks test.

Furthermore, financial evidence indicated the applicant's business generated more revenue post-accident.

The claims for IRBs and interest were dismissed.

Following an arbitration where the insurer was entirely successful in defending against claims for statutory accident benefits, the insurer requested an expense hearing.

The applicant failed to provide written submissions.

The arbitrator considered the criteria under Rule 75.2 of the Dispute Resolution Practice Code and found the insurer's claimed expenses reasonable and in compliance with the Legal Aid Tariff.

The applicant was ordered to pay the insurer's expenses fixed at $22,722.12.

The applicant withdrew his application for accident benefits at the start of the arbitration hearing due to a potential capacity issue.

The insurer consented to the withdrawal but sought an expense hearing to recover its costs of $11,211.69.

The arbitrator found that the applicant's claim was not frivolous, vexatious, or an abuse of process.

Emphasizing that the Schedule is consumer protection legislation, the arbitrator concluded that the applicant should not be financially penalized for withdrawing the application and ordered that each party bear their own costs.

The Applicant was severely injured in a motorcycle accident and applied for statutory accident benefits.

The Insurer raised a preliminary issue that the Applicant was precluded from claiming benefits because he was driving without valid insurance.

The Arbitrator found that the Applicant, who had purchased what he believed to be a legitimate policy from a third party, reasonably believed he was insured.

On the substantive issues, the Arbitrator awarded pre-104 income replacement benefits, finding the Applicant suffered a substantial inability to perform his pre-accident employment tasks due to cognitive and physical impairments.

However, the claim for post-104 income replacement benefits was dismissed as the Applicant had returned to work and earned more than his pre-accident income.

The Arbitrator also awarded attendant care benefits, finding the Applicant's family members sustained an economic loss, and granted ongoing housekeeping and home maintenance benefits.

The Applicant was injured in a rear-end motor vehicle accident in November 2010 and sought a determination that she sustained a catastrophic impairment due to psychological issues.

The Insurer denied the claim, arguing the Applicant's mental health issues were due to a pre-existing bi-polar disorder and that she was malingering.

The Arbitrator found that the Applicant suffered a marked impairment in the area of adaptation and that the accident materially contributed to her current state of mental health.

The Arbitrator preferred the evidence of the Applicant's experts and noted the Insurer's aggressive tactics in summonsing witnesses.

The Arbitrator concluded the Applicant sustained a catastrophic impairment as a result of the accident.

The applicant sought post-104 income replacement benefits following a motor vehicle accident, claiming a complete inability to work due to physical and psychological injuries.

The insurer denied the benefits and presented surveillance and social media evidence showing the applicant actively operating a holistic business, working as a life coach, and giving motivational speeches.

The arbitrator found the applicant lacked credibility and preferred the evidence of the insurer's neuropsychologist over the applicant's experts, who were unaware of her business activities.

The application for income replacement benefits, a special award, and interest was dismissed, with expenses awarded to the insurer.

The insurer, having successfully defended the applicant's claim for accident benefits at arbitration, sought $22,820.05 in expenses.

The arbitrator considered the criteria under Rule 75.2 of the Dispute Resolution Practice Code and the principle of fairness, noting the Schedule is consumer protection legislation.

Given the applicant's limited income from Canada Pension Plan disability benefits and the uncomplicated nature of the case, the arbitrator fixed the insurer's expenses at $2,500.00 inclusive of fees, disbursements, and HST.

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

Following an arbitration hearing where all of the applicant's claims were dismissed, the insurer sought its expenses totaling $125,698.25.

The arbitrator found that the insurer was 100% successful and had made a written offer to settle, entitling it to expenses.

However, applying the principle of fairness and noting that the SABS is consumer protection legislation, the arbitrator reduced the claimed fees by 50% and significantly reduced the claimed disbursements, awarding the insurer a total of $52,334.19 in expenses.

Following an arbitration where the applicant's claims for statutory accident benefits were dismissed, the insurer requested an expense hearing, claiming $32,402.64 in costs.

The arbitrator found the insurer's claimed fees and disbursements excessive for an uncomplicated Minor Injury Guideline case.

Noting that the Statutory Accident Benefits Schedule is consumer protection legislation and that the applicant received poor legal representation, the arbitrator fixed the insurer's expenses at a nominal amount of $1,000.00.

Following an arbitration where the insurer was completely successful in defending all claims for statutory accident benefits, the insurer requested an expense hearing.

The insurer claimed $54,029.63 in total expenses.

The arbitrator found the insurer's claimed hours excessive and reduced the fees to match the applicant's own legal costs of $24,423.47 plus HST.

Disbursements for two expert witnesses were also reduced to the maximum amounts permitted under the Expense Regulation.

The applicant was ordered to pay the insurer's expenses fixed at $29,798.52 inclusive of fees, disbursements, and HST.

The applicant sought expenses following an arbitration decision that granted her catastrophic impairment determination and medical benefits but denied her income replacement benefits.

The applicant claimed $66,656.94 in fees and disbursements.

The arbitrator found the applicant was entitled to expenses but reduced the amount claimed, noting she was only partially successful and had withdrawn a significant claim.

The arbitrator fixed the applicant's expenses at $16,122.84 for fees, including HST, and awarded no further disbursements.

Following an arbitration where the insurer was completely successful in defending against the applicant's claims for statutory accident benefits, the insurer requested an expense hearing.

The arbitrator reviewed the insurer's claimed expenses of $18,251.15, considering factors such as the degree of success, offers to settle, and the applicant's failure to comply with undertakings.

Finding the insurer's hours and disbursements reasonable, the arbitrator ordered the applicant to pay the full claimed amount of $18,251.15.